HomeMy WebLinkAboutBuilding Permit Application 1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -'� Ile) Permit Number:
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Building Permit Application JAN 2 0 2016
Planning and Development Services
Building and Code Regulation Division PERMITTING
2300 Virginia Avenue, Fort Pierce FL 34982
St. Lucie County, FL I
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Demolition
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Address: -1 LA tr
Legal Description: j
Property'fax ID CAS?, 5 jLot No.
Site Plan Name: Block No.
Project Name:
Setbacks FrontBack: Right Side: a Left Side:
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Elditlb—n-al-w-bffflo
�kn.....:`Yy ru r a'2M ti ,,, 5R '� �^k be nertormed under this permit check all t=appy:
0HVAC Gas Tank []Gas PipingOGenerator
Shutters Lam,Windows/Doors
Electric Plumbing Sprinklers Roof ,I
Total S Ft of Construction: �' F
Sq. _t S . Ft. of First Floor:
Cost of Construction:$ Utilities: Sewer ElSeptic Building Height:
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Name51- ._� 1`"4 � C Name: .`Y l^ pr
Address: ' -.1 'i i. i, iiAo �` ,. ,� t'-"
•- �-� �� t ,� r �� Company:�)�r_.l r;=tae ted�,z af"� rt,i � �
State: ft Address: /C 1 Al-(x8-') ) I
Zip Code: '' cTt-#pct Fax:
City: a tg'r' 't { State: -tW I i
Phone No. tib`'5 Zip Code: 533 1 Fax: _ I
E-Maik. ( -�tziy.)Yv Phone No.
Fill in fee simple Title Holder on next page(if different E-mail: k'`sc0t
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from the Owner fisted above) State or County License:
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ TGSAGE COMPANY:" .'C' 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 toyour 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 recordingour Notice of Commencement..
I I Si ture of Ow er/Lessee/Agent Sig , re of Con rac or/ 'sera a Holder
4
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The fooing instrume�nt ✓as acknowledged before me The forgoing instrument was acknowledged before me
this day ofl}GmiC 20 Eby this�day of Gr 20 ` by
(Nan person acknowledging) (Nam' of person acknowledging)
uuo 00,11 �_fQ� M' WMILA
aignat i e of Notary Public-State o lori a) (Signat r of Notary Public-State of Florida )
P,?isonallymown `x OR Produced Identification Personally Known l� OR Produced Identificaiopr,�r,� '
_i. `iry`pe iif'Iden_tification Produced Type of Identification Produced
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Commission No.. LYNN(y{ LER Com�b� NN WHEELER lee,Stat an
_ I _ o Fry Public,State of Michigan
CountCounty of Wayne
County of Wayne �i
Acting In the County of Acting In the County of - `
1tevised 07/15/2014 - - -
REVIEWS – FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLEMANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE a
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� a~,t'_lit/fPLE"I'E
INITIALS –