HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:. is-P-o 1 ou
RECEIVED
Building Permit Application DEC 3 0 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 X
PERMIT APPLICATION FOR: Window/doorEL
PROPOSED IMPROVEMENT LOCATION: -
Address:- 8/6o S coe-nn 1]r unit lo33
Legal Description: I S)a nd,, du n eS Cbrdom l n l u n ) A unit 103
P/K/n Rd m i Va I cyordorri l r�i u► n
Property Tax ID#: 3535 -OCj I -ME l - Ca) Lot No.
Site Plan Name: IYli1��,C ' Block No.
Project Name: 7yIPr Residence
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF-WORK:.
Rermave anO rep�QCe (a ) SI icj i n 9 G IQSS doors
l�1 A h i ni pocC t .
CONSTRUCTION INFORMATION:
Additional work to be nerformed un er t is permit-check all appy:
HVAC Gas Tank [:]Gas Piping _Shutters 2 Windows/Doors
Electric ❑ Plumbing Sprinklers Generator 0 Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ ��-�� Utilities:cnSewer Septic. Building Height:
OWNER/LESSEE: CONTRACTOR:
Named Alcyhetij
Address:.. d9 C7fC� � ,Qf�f' 1�1I1C�- _ _-' Company: .1 i�l� �''rLCZS,S I�rO�SSIOi�uS
City: Mr•bo Lr"._O. b State:ME Address:-SIS-70
Zip Code:040-1iL -: Fax: .:.:.;..°.:. City st-ki-r t _-. State: EL
Phone No.O0 _ BB3 q7�,59 Zip Code: 341q-1 Fax: 1380.04LoI
E-Mail: h:y If r c I' o Lr'l..P . r r Corn Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail: f-j-y l)fiS. G I(JSS joi'm0l- rnny corn
from the Owner listed above) State or County License:_153(63
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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 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 concurrencyreview: 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 our paying twice for
improvements to your propert . AN otice of Commencement must be recorded an p sted on the jobsite
before the first inspection. If ou I tend to obtain financing, consult with lender or n attorney before
commencin work or recor in o r Notice-of Commence
s
IOwner/Lessee/A ent Signature 'of Contractor ense Holder
gn ture of
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF QI"fl COUNTY OF o9artin
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this Ito day of AP_QAEM� 20 LS by this day of 1.1 eCCMbfr 20 /S by
�l�Yhcr 1 e� ho(/' L- apravle
(Name of person acknowledging) (Name of person acknowle ' )
(Signat re of Notary Pu lic-Sta a of Florida) (Signature of Notary P
ublic- tate of Florida
Y )
Personal) Known OR Produced Identification Personally Known Produced Identification
Type of Identification Pro _ Type of Identification PF
I�H FINFFiOCK 4 X 4�`:_ KEITH FI�NIlF� ROCK
Commission No. -_ ~ °'- Commission No. Y COMM� re7tN#FF165768
M ISSION#FF165768 ,oma;°
FoiFd*.' EXPIRES.,October5,2018, .
n5! EXPIRES October 5,2018
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