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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �f(D I 1 Cp Permit Number: RECEIVED Building Permit Application FEB 16 2016 Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Farr Pierce FL 34982 Phone:(772)462-1553 Fax:(772)46z-2578 Commercial Residential X PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of fine "i 1:>sw M - :i'_•f 1"' ^.bN x '. A 9. y, d ci��'' A ..4 `� -.^- "!F` s'!N+R'S �±.]• �r ,di :P r;wa`r�Sa.,. '-a't_ ' '3^.fw Y•,. �t'. i'b- `` F- - 'Ist,"a -,g�': Address: `��rJ �. t' iY�f:. CV-Cly Pa CT � L-tAC L_�Q- FL- Legal Description: L LJ 't.,Je, &6,A'tg-t� PLOLT )�©. oru- I-}+r I(Z Property Tax ID#: V4QLP" -70 5 — 00,32 -- 0th -9 Lot No. M Ptu_r-t e- Site Plan Name: _ -< -t Block Ncr n Project Name: Setbacks Front Sack: Right Side: Left Side: :.t• ":� Y' ar.5'+ ..� r ��r v�':e'Y��`n�.. .t� tCa ,i �b r i. #-:' t .a"-K.+.3._ ;:-�.�'�: 1GzC e S7_x 5-c a I e- CLo n v r r 1 o r)ee Ix I t t+ a- ne-..w 1-1 C Rut-�L> ,� 1Y1Ut .t.- A ltu' rz +t33-i N QnGt�i ?vrN -�tTX }A-Gt�l�r MC�6�1 rZ.A. V3W i �U C�v�tQ Its KW ..Q_tff_4-6c. Ro 3&f r y�..�yryY;,,,�. 3. •n , 3. w r � v- r' x it r$ �'r � Additional work to 0Gas ee orme un ert ispermit-c ec a appy: HVAC Tank F]Gas Piping _Shutters Windows/Doors 11 Electric F1 Plumbing E]Sprinkiers 0 Generator' Roof Total Sq. Ft of Construction: - SCI.Ft,of First Floor: Cost of Constructions:$ A1.1 "I C) d Utilities: Sewer ElSeptic Building Height: i , -• `: ..7e - .tkKra Yt4ca'�' '4 M . e Name L€,zt a- i olal rg�fK_ Name: %0 br)eikc- -- -- --- LLG Address: 54 e, C'_tr'�0_ Company: r 6D.rAa `-tar% City: pop of w ' Stater Address ;+Ve 6+ Zip Code: Fax: -` City:bel WQIC State: jP"(--_ Phone No. 'Z ? r 3 -c2l'3Cn Zip Code:,3Al$ _17; _ Fax: F-Mail: Phone No. TI a- 9'711 r- 1,56D Fill:in fee simple Title Holder on next page(if different E-Mail: Ag- SC from the Owner listed above) State or County License: (',ace If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. e�L�64 96 9t•aad Z•d 13ESlGNER/ENGINEER: Not Applicable MORTGAGE COMRANY: ____Not Appiicable 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 consuit with your Horne Owners Association and review your deed for any restrictions which may apply. to 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 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 iNARNING 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 commencin r recordinzwour Notice of Commencement s _Signature of Owner/Lessee/Agent Signature of ontractor/License Holder STATE OF FLOR)I A r STATE OF FLORIDA COUNTY OF COUNTY OF \)tQ' �-� The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me thisItAdayof_ 20I by this day of ?FP�6r 21D by (Name of person dcknowiedging) (Name of person acknowledging) 141 J & &W—OvZt�1— (Signature of Notary Public-State of Florida ) nature of Notary Public-State of Florida} Rersorianlry Kpcawn- _OR Produced identification Personally Known OR Produced Identification - j..P o ce Type ofldentifica ion Produced LINDA MARIE BOUCHARD fp. + bC4M1VA6SION#FF125526 (Seal) o UNDA MARIE 80 t _HARD (Seal♦. ? 4;XPl3i�S May 21,tot 8 MY COMMISSION#PF125526MITI - - _ r EXPIRES h4ay 21,2018 Reised 7 " Zt?14 (07Jry98-0t53 Fsoridallotaryservice,com - ... .0 /to/ REVIEWS FRONT ZONING SUPERVISOR PLAINS VEGETATION SEA TURTLE MANGRCdUE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE i COMPLETE ' INITIALS �tr��t•b 91.9 qad C-d