HomeMy WebLinkAboutBuilding Permit Application i
ALL APPLICABLE INFO MUST BE COMPLETED FOPAR ACCEPTED
Date: � ' � ' I 1.0 � MAR p 3 2016 Permit Number:
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A M `n1 PEPrJIITTIPIG
® St. Lucie County, FL - —WED
Building Permit Application
Planning and Development Services MAR 0 120%
Building and Code Regulation Division PER:>lIITTING
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County, FL
Phone: (772)462-1553 Fax: (7I2)462-1578 Commercial _ Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATIOINJ
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Address: i 1 We 1r;26 1 ausozi '-8eweH at ..(3/Y�3 7
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Legal Description:�7/klN7/S I / 3 S 6A uiur / ,70/ lq/UIYWKd 7/474 9i/�9,E 11(J
$kF.MrWi s rOR 36-71-2835-)
Property Tax ID#: S!l- SIf�r 0oo4-D�o-y Lot No.
Site Plan Name: "UAP) S!6Af3F-�k Block No.
Project Name: I LYIvlyj) Sb/C oCF_1<
Setbacks Front Baick: Right Side: Left Side:.
; DETAILED,DESCRIPTION Or.F WORK' :Y
CONSTRUCTION- INF_O_ R-
Additional work toe e orme� ' under this permit—check-all appy:
HVAC Ei Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing OSprinklers Generator Roof
Total Sq. Ft of Construction::-7 I S . Ft. of First Floor:
Cost of Construction:$ 3 I d 0. Utilities:Sewer OSeptic Building Height:
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'O{WNER/LESSEE �Y r`tC0_ _NTRACTO;R {
- -
Name pUj ` TSH "Name:
Address: Company: A n-& Fp ov1pe SRK7`(6PL NP
City: State: Address: 1)y e6 SE 6, 07A1LJAJG- lbetve
Zip Code: Fax: � City: 140f3F. S dCtNI_) -I
State:
Phone No. Zip Code: ,33)15 ,�r Fax:
E-Mail: Phone No.
Fill in fee simple Title Holder on next page (if different E-Mail:
from the Owner listed above) State or County License: 011551
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CO'N�.S�T,,-R,,UICT I OUIIMIA W1 ;,, INF0,'R'M'ATIONr a4.
DESIGNERANGINEER• _! Not Applicable, MORTGAGE COMPANY: _Not Applicable
Name: �jAjNV TOif'1.
yl .. -.-- _ Name:
Address:, l In � 2 rn A VQ—it I DO Address:
City:_'_D-et �� a State:`F_ City: State:
Zip:- 3344 Phone:_4 5df�3g Oly1o0+ Zip: Phone:
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FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: I Address:
City: I City:
Zip: Phone: I Zip: Phone:
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I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no represent I tion 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 plan s,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 yo intend to obtain financing, consult wit n r or an attorney before
commencing wt our Notice of Commencement
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_Signa re of Owner/Lessee/Agent Signa ure o Contractor/ c nse er
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF WL2r tJ n
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this M day of V? I. 20 LLo by this 29 day of_ 20 UE_by
Michom znn-e I . MIchoo 2Glrf,tt,
(Name of person acknowledging) (Name of person acknowledging)
clulll� rh eA."
(Sig at a of Notary Public-State of Florida) (Signa ur of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally KnownO
P oR Produced Identification
Type of Identifi ion - — Type of Identification duced
,SSL S;I�
f!"111,1111j,�,1,, JOANNE INEEHAN
Commission No _>: . .t AN P11134C.[SeRlbf Mr,ic+a CO eal)
9 Commission No.EE 842236 .t JOANNE MiEEHAN
t• Q.� .`pPf PU�y
M � "$�•• f�
Commission No.EE 842236
Revised 07/15/2014 '�� ;; My Commission Expires 11/23/16
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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NITIALS
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