HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 03- 0"1 tba ,
III I RECEIVED
Building Permit Application MAR 0 8 2016
Planning and Development Services PEPMITTING
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
PERMIT APPLICATION FOR:
Address:
Legal Description: L&UA-WWA PDA-
1301- 601-0101-000-0
Property Tax ID#: Lot No.
Site Plan Name: Loi 11-joL r^ so'cley Block No.- 7
Project Name: (M i 11,*(OLCV\ or
Setbacks Front Back: Right Side: Left Side:
InSfaff like Car 11ke ano-ra4z door 9x7
Additional work to-bep–e-ft-rmed Under th s permit–check all that apply:
—Mechanical —Gas Tank Gas Piping Shutters V"Windows/Doors
—Electric —Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ law - 00 Utilities: Sewer Septic Building Height:
Name Wtitiarn 19 ax kP Name:
PlcG Zion
Address: 760(, T^e,%es P( Company: MM Enj=,rise_ oc &ewd
City: of P*ferce state: Ff Address: 005 Toriabao- le Ti
Zip Code: . 3q951 Fax: N A City: lndim J4,arbow Ge-z%-- State: Ff
Phone No. 77.7- 571-8552 Zip Code: 3293? Fax: 32.1- 777- YZ3 41
E-Mail: N Phone No. 772-337-4Y70
Fill in fee simple Title Holder on next page if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is 2540 or more,a RECORDED Notice of Commencement is required.
N-0
DESIGNERANGINEER: Not Applicable MORTGAGE COMPANY: 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: T
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.
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'A4W'� 6r"M490T__ - s
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORl�A
COUNTY OF -DirtQa d COUNTY OF Cjt��
The forgoing instrument was acknowledged before me The forgoing instrum nt a�owledged before me
this "L day of Meo-ch 20 1(p-by this `2. day of NI 20 L(p by
s -+ S S
(Na perso ck wi dging} (N of son a owl dging)
a,W- - .
WaIOR
-State of Florida) a P lic-State of Florida)
Produced Identification P o ally K n OR Produced Identification
ced Ty f I entific on Produced
No 2. ° ai 8
Commission ;�ol5ea B fission No.F Se } R
ROOi�ESZlGETI =*; *, GE7I
MY MyCOMMISSON FF2
COMMISSION S FF2 `: XP
s F.•QPa, E IRES:June
p,;,�.•` _Bonded Thru Nptarypublic Undenadters trYPobGc underwrite
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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