HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFOMUSTBE COMPLETED FOR APPLICATION TO BE ACCEPTED ?f
Date: Imo/ tea Permit Number: 1 (po)-� -93--
��■■SII■■■111
I' RECD
ED
Building Permit Application JAN 2'7 2016
Planning and Development5ervices
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:
------------
Address: .�yd� �• 1 A
Legal Description: i �C� IP4 YY (� Uanet"� MOn !�p' b- j�T1(0,60r!C)(or Apar
Property Tax ID#: 34 014-0-7- Dom 000- Lot No. 2
Site Plan Name: __�� Block No. -� R
Project Name: r4-+vy m l:L r)?a/76?p
Setbacks Front . Back: Right Side: Left Side:
1 rzSf l like far UP–Ct2 15t vane door
Wditn
lonaWworto a pe orme under t is permiR–c Wall appy:
—Mechanical _Gas Tank _Gas Piping ^Shutters ✓Windows/Doors
Electric _Plumbing Sprinklers ^Generator Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 214(f5.oo Utilities: —Sewer _Septic Building*Height:
Name. Name: -'+ t_ jAnna
Address: ?1 Pied tion
tt l.!?. Company: ti'tryt�,r��n<ise af' &e_uc.���,��7c
City: CYT 1�r state:FL Address: 00b "romahaa3lt Ty
Zip Code: D0792 Fax: tJ/A- City: InAian lid.-$oc-V eeact'e State: Fl
Phone No. Zip Code: 3Z,?3-7 Fax:_ 3Z1- 777- Y—Z3 U
E-Mail: WA- Phone No. 772.337. y70
Fill in fee simple Title Holder on next page(if different E-Mail C;ukesS stun ci ho.�•c am
from the Owner listed above) State or County License:
if value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
WE
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: r 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:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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, 1 do hereby agree that I will,in all respects,perform the work
in accordance with the approved pians,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
commenci,pg work or recor irjg your Notice of Commencement.
Signature of Owner/-Agenf/Lessee Signature of.Contractor/License Holder
STATE OF FLO � STATE OF FLO
COUNTY OF_._� ���, _ COUNTY OF Va
The f r oing instrurpgnt was acknowledgqq before me The for oing instrunlent was acknowledged before me
this day of CUA 20 Q by this day of G f� ,20�by
U k'5
(N m �o ers a noedging) pers knowle ing)
I o y P lic-State of Florida) nat e bli State of Florida)
P rs OR Produced Identification Per n =:)
OR Produced Identification
Ty p of I en i scat' n Produced a Produced
C ?„' BROOKE SZIGEn
Commission No. Ezr 29�55 BROOKE SZIGE1 sion No.if �!� .- ; 'Py, al
MY CQMMISSIQN#FF 4A655 �--`� :., E�AY CQMMISSioN#FF 2
H:, 4K EXPIRES:June 25,2019x; EXPIRES dune 25,2019
tum6derw0ters 1- Bonded Thor Notary Pubrio Undeffid
41” t,
REVIEWS FRONT ZONI G SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.7/2014