HomeMy WebLinkAboutBuilding Permit Application Sep 02 2015 13:22:51 Via Fax -> Vonage Page 002 Of 004
AU.APPUCARLE Ii11FA MUST BE COMPLETED.FOR APPLICATION.TCR-BE.-ACCEPTED',*.:
'. ".." :. .:..:...
Date:• Perrriit;iVumer:
pp lical ion ,
-Planning and Development Services
Building and Cede Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 �, �
Phone: (772)462-1553 Fax: (772)462-1578 Corr mercia9.__.. �"' _ . ...__ Re•5iden`friai __.
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of I ne , ••w.
_ �
Address: �^� .��"a �l�"_�r�L�; �'w��. �•'1 �� �,�))' 3 �i
Legal Description: !� - f_ , 4�.` 'lr'•a c^�.1 t�1' t c'.4y' )'r 6
Property Tax ID lifer tG_�� r �� c lot No.
Site Plan Name: .
Block No.
Project Name:
Setbacks Front Sack: Right Side: Left Side:
07
Additiopal work toe e orme un er' is perms .-c ec a apply.,
lir I_IVAC LJ Gas"Dank Gas Piping Shutters Windows/Doors.
Electric Q Plumbing Sprinklers :: •`(5ene.rator .0•Roaf
Total Sq. Ft of Construction: S •:�l"t::-of'F" t.,Flaar:
Cost.of-Car,strtiction:$ s �'-T '• Utilities:.. Sewer : Spptic".•.. Buitding.Height:
Name f �" :N'at►ie'.':.:T . : , y''
Address-__86L. .1 y r� '�. �;arirj5any, � �_ •, �..d? '�'°'C:�-+<Ils'
`'sty: •: # . .� State:
Address, f .•
zip'odic, Fax. City, P- -• tia.,��r State:.
t
Phoite N . iC -1000� zip code: � `� , . Fax: J cay....rr ,�.......
E.-Mall:
Phone Na. 'j'� ?!�ti i 7
Fill in fee simple Title Holder on next page(if different E-Mdi.l:
from the owner listed above) State or County License:
H value of construction 15$2540 or more,a RECORDED Notice of Commencement Is required,
Sep 02 2015 13:24:86 Via Fax -> Vanage Page 003 Of 004
9
"OESIGMER"ENGINEER: Not.Applicable MORTGAGE COMPANY, v"Not applicable
Name: Name:
Address: Address:
City: .--',,,.State: � City: State 1 .
Zip: Phone: zi•p:_ Phone:
FEE SIMiPLIr•TITLE HOLDER: i.f Not Applicable BONDING COMPANY,, Not Applicable
Name: Name:
Address: Address:
City:
Zip:
Phone: 7i Phone:
— p� .�_..,.,..,�
l tertify-that rio-i cork or installation Has commenced prior to tF,e'.issu nt 'of a
St.Lucie County makes no representation that is granting a permit will..authorize the:pertYi.'it holder to bulld the subject structure'•• •
wl•iicil is in confiirt:with any applicable Home owner,AssOtiMiOrl rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Associationn and review your deed.for any restrictions which may apply.
In consideration of the granting of this mquested permit,I do hereby agree that i wi.P,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,suns,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 jobsiti�•'- '
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recordin&your Notice of Commenc6ment:
•,.. ,. .. : Viµ;";,
SjUr9fu
re of Owner/Lessee/Agent ure of Contractor f Lien e HoTder
STATE OF FLOR � STATE OF FLORIDA".....
COUNTYOF L . �. COUNTY OF-- -) ^L a�.ot �• _
The forgoing instrurr+enl.was acknowledged beforeEme The€orjoing Thstrument.was acknowledged.beforEy
this' day of �r •it3• .,. Zo by ,
't ;. .:.� ZO 'by::• :.
"�' yq,A e v"' J C�`r-rr..n'_": ��.� -EL"e'
(Namk,or person acknowledging) 1111"A tf1j/p�®{VIP&
(Name of person acknow1odging)
(sign a �Jf�iNM1!u"VAIEr ROf Florid'j °� cn.(5 naturae
^� fWFF195337• z '•' '' '�~• ��g araEt3hr* •a,�• °'��a
`Personally Known OR.Produt d• CSIV .• sanai(jr Khauvn' m' `Of;.iProtiuce i ts#
Type of ldentifit"btion Produced _ '''h"y"� �` °tl "5 " � ii of Id`etitifi atiort.ProducPtS
Commission No. / J37 (Seal) :. rtfFi•ilftVi►i►O Commission No.+ =��` :w(S aI) i}1 .185337 s
A" 44g
)devised 07/15/2,014
REVIEWS FROiVT ZONING SUPERVISOR PLANSII VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW'` .I ''REVICW REVIEW ' REViEW
DATE
COMPLETE
INITIALS I