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Home My WebLink AboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ��3d1�rJ Permit Number: l 5c�-1 —d 1A( RECEIVED JUL 3 0 2015 110111 a Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line aa Address: 17tog- GLP��EEs Legal Description: Property Tax ID#: II-U 000 01ID Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: KENN '� *'h ' .,�,* �, R_Irl 42 Additional work toe e orme under this permit—check a appy: HVAC E]Gas Tank ❑Gas Piping _Shutters Windows/Doors ffElectric' 0 Plumbing OSprinklers Generator a Roof Total Sq. Ft of Construction: S . Ft.of First Floor: 0 Cost of Construction:$ (�0.4 Utilities. _Sewer Septic Building Height: �. , . IgN � ; $ 5 ,,., � � BOOM�z"`s.F, ...v*NS' RIVEN- ,'. {'.`,nSC°s:., °-,_� Name Name Add ss: obc)6.q(A ,G >:F Company:... 'hlitC©�( (;:�L�� C' City: L.LeGE�_ State: Addre l� � G % �, Zip Code: � � Fax: City: _ Stater Phone No. 722-s97L 1401t, Zip Code: 3490 Fax: 2).2-4 - bl 34 E-Mail: Phone No. Fill in fee simple Title Holder on next page(if different E-Mail: 11A 79 AM , Co," from the Owner listed above) State or County License: (� 7 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable . BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: I certify that no work or installation has commenced prior to the issuance of a permit. St.Lucie County.makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work in accordance with the approved plans,the.Florida Building Codes and St.Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review:room additions, accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to.obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. Signature of Owner/Agent/Lessee Signature of Contractor/License Holder STATE OF FLORIDA STATE OF l S.�� COUNTY OF ORIDA�•I�,ACt� COUNTY OF TheLdayof ing instryment was acknowledged before me The forgoing instry_mwen was acknowledged before me J 20 Eby this�day of 20 by �S l� (Name of person acknowledging) (Name-of person acknowledging) (Signature of N (Signatur P bl' -State of Florida) SALLIE WILSON KESNER j��AQ , SALLIE W LSOPersonally Kno w 0161 Beg#It�tNIM90 Personally - �}��J�(u� �� 10Ji'dcan y Camm.Expires Nov 2;201 o loType of Identifi r' Eek Type of Id i9fF OF ,` Commission#E FF 1 19'•1.,,.. Bondeditoto NotaCommission V rr 14 ry Assn. •,��,�.% - Commission No Commissi BDWd!_hrou NatforwN Revised 07/15/2014 REVIEWS - FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER - REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS