HomeMy WebLinkAboutBuilding Permit Application JUN-23-2011 13:57 From: To:7724621578 Pase:114
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 0�
Pate: � r '
- I Permit Number: (/
;•y ,;� _ , RECEIVED
Building Permit Application SEP 17 2015
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
crI,:Y�:•.":Yr:..::i. _ _ •:S:".:•: :�i":{rte.::{o.;
Address: Ww�ProciI SJ. Lc�Q i- L _-,W98(c�
Legal Description: PDD .2 DA a� +k 41 re3 n-Ile- CU ilg_ . "�<-r
104- (4 3 AAA 12_3 2'x.5)(0 �
Property Tax ID#: J 060 1 - CLOS 000- 4( Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
_:r;a ..y.•• :'V.:; :•:f;,; a,•,!., - •.;.. ,^c(:h if." 'r.75'c% .:.5:.,
�"i 1 C : K
1 t-1 5 E
c . .. ... ..... .. : .
..,...,..:
Additional work-to e e orme under this permit,c ec a apply:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
❑Electric E]Plumbing Sprinklers ❑Generator ❑ Roof
Total Sq.Ft of Construction: 5 .Ft.of First Floor:
a$
Cost of Construction:$ d2 So 0 Utilities: _Sewer❑Septic Building Height:
�i '.� :fir'•.`•:;
:_:, is• �i.. '
NamefejCfa.l Nlg-J'(_ MorA!� As1c.�c, Name: AI<Kao e(
Address: (42) I _7u� Eg,(k�.>_4s_ Company: ,.bled i r^ Cbn�]t�;rq-\in�l_
City: state:_T-X Address: r-) !1)Ljr-) _� f
Zip Code: f Fax: City: M Q M i State: F(,
Phone No. q.-A:) ' 9 711- `1(�{�3 Zip Code: � 1512 Fax: -q
E-mail. -- — Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail: qa-(o!e-i Q I f ce) �1n'�Cx i t• C a!m__. ..
from the Owner listed above) State or County License: CA C I�3 12-45
If value of construction Is$2500 or more,a RECORDED Notice of Commencement is required.
JUN-23-2011 13:58 From: To:7724621578 Pmye'2/4
DESIGNER/ENGI NEER. 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 ermit holder to build the subject structure
which is In conflict with any applicable Home Owners Association rule��bylaws or an9covenants 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 anoth&non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencerniaht 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 jowrecording your Notice of Commencement.
(12/
;Lr o ner/�LesseejAgent Sig(wkdfr��Xtractor/License Holder
COUNTY Of U whl 1 1)QM COUNTYOF 8_6A k_t
The fing ins trunient was,acknowledged before me The forgoing instrument was acknowledged before me
(Name of person a c dging) (Name of person ck ledging)
(Signature of Nof"lic-State of Florida (Signature 4of1hNblic-State of Florida
Personally Known OR Produced Identification Personally Known QR Pro uced Identification Y
INALVIS MARTINEZ
Commission N
EXPIRES August 14,2011B
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PONS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMIIETE
INITIALS
'