HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 11
Date: Permit Number: 1 �0q.nq(0(D
RECLINED
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Building Permit Application AUG3 2015
Planning and Development Services 1
Building and Code Regulation Division PERMITTING
2300 Virginia Avenue,Fort Pierce FL 34982 St. u e Cov-t
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line - S`
PROPOSED IMPROVEMENT LOCATION: -
Address: 106 ., 7( SOLgcirA Gil PL► hl, .3M13
Legal Description: 8& ffAK 1111r7 AI K �Q I
Property Tax I D#:?�� I "�/ " 0�0�" Db(7' Lot No.�
Site Plan Name: k0046WR 91-OL Block No.
Project Name: IWQf/r'&( /; C Ned
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
bt)ltt 0 WAO' �
� (�Nd/N�� 06, CAF-Arr 69 PACS
CONSTRUCTION INFORMATION:
Additional work to e performed under this permit-check a appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers E Generator 1-1 Roof
Total Sq. Ft of Construction: 15,E S . Ft. of First Floor:
Cost of Construction:$ Utilities. Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name UC Name: 3Y6,
Address: Company:
City: Pvrr 5Y.. Iwe_f1; State:61-1 Address:3 /"?5A/M "4G
Zip Code: Fax: City: .51State.&-
Phone No. Zip Code: �� /�>,� Fax:
E-Mail: Phone No. 7V-20-TKfb
Fill in fee simple Title Holder on next page(if different E-Mail: 71 f & Aft„ C04k
from the Owner listed above) State or County License:C&_
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
ti
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: C 0 4rName:
Address: A06 Address:
City: FT 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 thepermit 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 Comm encemen .
s
_Sign ure of Owner/Lessee/Agent Signa ure of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA ,
COUNTY OF S : ,mac: COUNTY OF —%,tAW
The forgoing instrument was acknowledged before me The forgoing i trument was acknowledge¢before me
this day ot� 20 Eby this day 204S by
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( me of person knowledging) (Name of person ac nowledging)
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Signature of Notary Publi - tate of Florida) ( ' urelbf Notary Public-Staip of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced -
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Commission No. ^- Seal Sre.riNa.rr.c+�"M Commission No.
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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