HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q
Date:.. S'1D.., 1(42 Permit Number:
Building Permit Application MAR 10 2016
Planning and Development Services PER,10ITfING
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: To Select from dropbox, click arrow at the end of line
PROPOSED IMP
ROVEMENT.LOCATION. .
Address: L a NC- N 0 Id IA .4,'��
Legal Description: Lo 7 1 p10 &CDC, 9 q, ViGG4.
Property Tax ID#: Lot No.2�
Site Plan Name: / P IZ Block No
Project Name:
Setbacks Front C Back:C)Right Side: Left Side:—CZ
DETAILED DESCRIPTIO,N.OF WORK
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41 ;6- aAd "le 64* mu A
CONSTRUCTION
INFORMATION:-
itional work toe e orme under this permit-check a app y
HVAC Ei Gas Tank ❑Gas Piping 1:1Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers MGenerator #of lrewc e.
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 3 g'� Utilities:Sewer ElSeptic Building Height:
bW.N E R/,LESSEE CONTRACTOR:"
Name f s:' Name: �tk1Le I etwta.�
Address:ld/ Ne &&&, a Company:Ve4 /'-
City: 10S or StatePOY Address: 2/oo-G SW eona►ti 3< .
Zip Code: Fax:226'.0 4 /mm2 City PSL State: f2
Phone No. 5'"7 q —3 a Zip Code: 3 g4r3 Fax:7?2-8?F-160F
E-Mail: Phone No.I??2-/p1f'-23S�8
Fill in fee simple Title Holder on next page(if different E-Mail: cdc(,e, a)c4Cr4r,,%,,0
from the Owner listed above) State or County License: C,dKf0
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
EN:LAW INFORMATION .. . ;.
SUPPLEMENTAL CONSTRUCTION LI l
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
commencing work or recording our Notice of Commencement.
_S gnature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA ��"" k
COUNTY OF �6 LVc .2 COUNTY OF S7`[yG l e
The forgoing instrument wa acknowledged before me The forgoing instrument was acknowledge before me
this_'J7 day of/�7A40% 20�by this JV of _ .20 �v by
/ht�il��"L 1 �.�,�-•� Irk ► c L ;�� 04 /fie�c•-n�-•1
(Name of person acknowledging) (Name of person acknowledging)
la C�� X:�� la 44'.
(Signatureof Nota Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Iden ca n Produced Type of Identificatio Pr ced
�c{q c w F1�k�
Commission o. e. / .r;: (Seal)KIR ARI KATZ Co mission No. r e� (Se AFL'1
MY COMMISSION#FF04924 's " MY COMMISSION #FF0.44
j-NA: QQ,
Revised 07/15/2014 (407)398.0153 FloridallotarySorvlce.cotn b�7I °®�� Floddallofat.t::'t%r.r,cnnt
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS