HomeMy WebLinkAboutBuilding Permit Application Feb 1816 02:34p p.2
ALL APPLICABLE INFO//MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED )) I
Date: i81�� Permit Number: Lo )_^(2 l
RECEIVED
Building Permit Application FEB 18 2016
Planning and Development Services PER[CJI ITTI NG
Building and Code Regulation Division
St.Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential 4__
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT:LO.CATIO'N:::'` CX
Address: 5v2-21 S, .AP-ItY 7_A&7-gM CT
Legal Description: ! S-9eA*tn.-1a{, e L 4 Q f.44Se- .2
Property Tax ID#: 3 yoZY ` 7C,2 - 00,27- 6Oo- / Lot No. 7
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Sfde:
DETAILE:[?:DESCRIPTiON..OF.WORK:.
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CONSTRIlCTIaN. INIFORMATION:'-.
itiona wor to Orme un erPGas
ermit-c ec a appy:
❑HVAC OGas Tank Piping Shutters E]Windows/Doors
Electric 2Plumbing prinklers Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ �� Utilities:0Sewer Septic Building Height:
OWNER/LESSEE: -.CONTRACTQR.
Name /Yl�t st,r�7� Gr l,Jy/Gar Name:, .TbS Q/! A' 7'uZzY
Address: c Company: 6 e.iet,t
City: G A4-t i e- State: reL Address: I cI 62 Sdr Bo/fir,.. IRR✓�
Zip Code: Fax: City: PS 4- State: C
Phone No. 77.2 8 b 7 /3 Zip Code: .1 yFax: 331- �68a
E-Mail: Phone No. $3? 369.2,
Fill in fee simple Title Holder on next page(if different E-Mail: S e'v2s4C�G.-.-r.6,A
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Feb 1816 02:34p p.3
SUP:PE,EMENTAL:-CONSTR.U&-IbN:LIE-N t�W li1fFQRMATtfJN:.: -
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: i 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 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 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
commencing work or recording our Notice of Commencement.
_Signature of Owner/Lessee/ nt Si ature of Cont ar�ctor License H r
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrum was acknowledged before me The forgoing instrument was acknowledged before me
thisl fay of 20 Eby this—,^ay of Ae d 20 Z by
(Name of person acknowledgin (Name ofp son Kknowledging)
Signature of Nota lic- a of Florida J ignature of Notary Pu lic- ate of Florida)
Personal ed Identification Personally Kn .diti' �`fro uce den lcatr n
Type of I on Type of Identi 7 - uaMM+SSION*FP233682
EXPTRES ay
My COMMISSION#FF23364 1)3QU 51 Flondallo.IryAwvlt
Commis evoior�" y21 al Commission
444/1 3904j'63 F1pnAalloa ySorvice:eGr
Re-Ased 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW -REVIEW REVIEW
DATE
COMPLETE
INITIALS