HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: s.2 W Permit Number: I CJ
EED
REC EIV
Building Permit Application MAR 0 8 2016
Planning and Development Services PERMITTING
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: 500I For+P iMtht\rd-
Legal Description: 1aW%1C9J- Vav-k--Uniib-ld L 1-1 LO+15 WQ�N14W (Oir:11A-22-1
C C-OLSe A(1)- I52-EPN -2(o SA
Property Tax lD#: Lot No. IS
Site Plan Name: .- Efaz l ciarvo Block No. 11
Project Name: (h=iat An i(L- (dot kvoh+CJ6 46afl, ('I(kJA-X' ( ty4 -moi
Setbacks Front Back: Right Side: Left Side:
Easfojl IiIce ke- fat Ilk !4evaat Joor-�y, �x-7
Additional war k-to-be-p-eirformed under this permit-check all that apply-
-Mechanical —Gas Tank Gas Piping Shutters v`Windows/Doors
—Electric —Plumbing Sprinklers r Generator Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ _2941 le- Utilities: —Sewer _Septic Building Height:
,Name fja7el Name:Ioraunm Lj��'
Address:
3001 6rf--Pi-et-rr--8wd- Company: MiWLrAfarise ac 6rema 64
City: For-4 Pierm State: FL Address: t 148 7v�»uharJir 1>r
Zip Code: -Y
A51 Fax: City: IrzUux )4,arbv&, (?each. State:- F1
Phone No. M2)2t?-13cy1 II
Zip Code: 32937 Fax: 777- q23q
E-Mail: NX Phone No. 772-337-VII70
Fill in fee 4mple Title Holder on next page if different E-Mail:
from the Owner listed above) State or County License:
if value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
rv: •rr..,Y— �n rk��"a a..,; r'"; `' - 6
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gF7T"'a.?t._u'„ r.;u .,�s � �+?.,..nt; ,..t?`.«`l,�,�,fis�,. .Ir R .�t. }i':. ' .3''Sr�ef ,vc?.s ;x`•?�r,3'r:
DESIGNER/ENGINEER: _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:
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
commenciDZ work or recording our Notice of Commencement.
s
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLO IDA STATE OF FLORIDA
COUNTY OF IrI)d n `COUNTY OF L ard
The forgoing instt �s acknowledged before me The forgoing instrument was acknowledged before me
this T day of Nl l l(1 20 1_�o_by this 7 day of hA C� ,20 t(o by
L�t�-es s
( ers a, wled 'ng) (Na of pers4 a owledging)
aur ubic-S ate of Florida) at o a blic-State of Florida)
P rs ally Know R Produced Identification ers Ily Kn OR Produced Identification
Ty o icatio P o ced a of I is 'o Produced
Commiss Ul (Seal) Commission No. (Seal)
A MY COMMISSION A FF 244655 =•; �_ MY COMMISSION 4i FF 244655
Revised 07/15/2014 s i -'EXPIRES:June 26,2019 '� EXPIRES:June 26,2019
Bonded Thre Way Public Underwritersgas WWWOMM"
�Rtr,>hBonded Thm Nolu Pub Und
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS