HomeMy WebLinkAboutBuilding Permit Application 03/25/2016 09:55 7727811307 FLYNNS AC PAGE 02
ALL APPLICABLE I FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED // ,,ll
Date:�e Permit Number: ( u U;
Building Permit ,Application 2 ZOO
Planning and Development Services MAR
Building and Code Regulation Division
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
Address: lu 0Q p a Yl tin SC)
Legal Description: ' 1 l.I '1/l Y1 1 CLQ
•' �- U -
Property Tax ID#:�n1-4 5 H — 5'1 MS 3-•oo"( Lot No.
Site Plan Name: a.r Block No.
Project Name: (-
Setbacks Front Back: Right Side: left Side:
T Q-V k0..k_Q, D` Z-A-0,� 'PAG V l>�
r � w 1 4--V'N -s Kik)
�Ll SA
Additional work oe e orme un er t is permit-check a appy:
[&VAC ff Gas Tank []Gas Piping F1_Shutters ❑Windows/Doors
11ElectricEl Plumbing []Sprinklers ❑Generator Roof
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ (pf (Pb C D Utilities: Sewer❑Septic Building Height:
Name e--> jVte_(_tk,"W Name:_ D `�.2-�� L V A+n
Address; 10 `d0 S- O UCLAk 'tX 5-0(a, Company: -4:�-l4 hn'S A C _S9_V 01 G ll, .&'-
City: S+?iY\ -?a A'e'k Stater Address: f 3,�2 S �' -4. ,
Zip Code:_ 3 LA.1 S ') Fax: City: _-RoU w�_ LC 4- j State:
Phone No._(P_ [ " '5S;_2. qY Q� Zip Code: 5q Fax: 7.�-
E-Mail: Phone No.
Fill in fee simple Title Halder on next page(if different E-Mail:� ) nv)e2 0 ,C_,/JAe _q hidW
.K. �
from the owner listed above) State or County License: CA C f)5 S Y $2,
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
03/25/2016 09:55 7727811307 FLYNNS AC PAGE 01
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 thepermit 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
commenting work,or recordingyour Notice of Commencement.
Si ure Of Ow r/Lessee/Agent nature o ontractor/License Holder
STATE OF FLORIDA STATE OF FLORI �
COUNTY OF dY� A i n &Y-4A�qCOUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument wasacknowledgedbefore me
this;�day of Mgr -Ar 20 ,�(�by this day of 1M&('LX\ ,20 (,by
;..'gip S.Q_G'L\, u yl 0 .
(Name of person acknowledgin ) (Name of persoh acknowledging)
(Signature ofotary W lic-State of Florida) (Signature of Notary Publi State of Florida)
Personally Known. OR Produced Iden i Personally Known OR Produced Identificati
Type of Identification Prod MtCI� J Type of Identification Produced J.
BKVWV-
NOTWY
FLS` WAARYPUMU
Commission No. $Y ��111� wM Commission No.
•L�' �V��fw•8 r 16
cum
bm—
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS