HomeMy WebLinkAboutBuilding Permit Application Jan 211OU8:52a First Choice 7728707860 p.2.2
'
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: all
RECEIVED
Building Permit Application JAN 1"'11 2016
Planning and Development Services 'TING
Building and Code Regulation Division PERN111
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie QoUnty, FL
Phone:(M)462-1553 Fax;(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address-Z05 01N_e,__Pb1Co9cA S�,Lor-!E4 F1 , 39!q%4_
Legal Description
Property Tax - Lot No
Site Plan Name: Block No. 11::4
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
ElElectric *umbing [:]Sprinklers 11 Generator ORoof
Total Sq.Ft of Construction: So.Ft.of First Floor:
Cost of Construction:$ Utilities:[JSewer OSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
City: n_L - State:RL Address %;&a%XAh-- JNk^
E-Mail: Phone No
Fill in fee simple Title Holder an next page if different E-Mail.�i
from the Owner listed above) State or County License*17
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
'
Jan 21 16 08:52a First Choice Plumbing 7728797860 p.3
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 TITLEHOLDER: _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 priorto 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 re orded and posted on the jobsite
befor irst inspection. If you intend to obtain financing,consult lende r an attorney before
cpMmencing work or recording our Notice of Cc mmencerrient.
Xe
1 s
_Sign ture of Owner/ essee/Agent Signa a Contractor/L cense Holder
STAT OF FLORIDA ST T OF FLORIDA f`
COU OF LI,L C UN OF
Th or of :nstru ent was acknowledged before me he fo oing instrument was acknowledged before me
s a r of .J A/U' ./ ' 20 16 by this dray of ,!/Ati�u�� ,20 by
(Name of person acknowledging) (Name of person acknowledging
(Signature of NotaP lic-State of Florida) (Signature of otary Pu ic-State of FIo ida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced [ Type of
ldentifica]tii6n Produced /�--
Commission No. O 6�7 ' (Seal) Gti,�� r Psi No.C�� -3� 7a (Seal)
c -10 N g30_
1Y CONi4A1„,a 2018 �—i Al lGFOF+1)
,n� PIR .co #t E�8342
Revised 07/15/2014 ;;��,ss X F Sarva o Iy�Y CO4dw11 oG tuber 12,2016
EXF1RE�s _Cam
<tl7)398•�ti�3 'O •
REVIEWS FRONT ZONING SUPERVISOR PLANS VE N SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS