HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1
Date: � 'l%� Permit Number: ! _
Building Permit Application APR 1 3 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: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMErTN,T LOCATION:
Address: (p I r �� "� 9�
Legal Description: !Luer 9b-s� S2_ z
Property Tax ID#: �JL} \a- C( 2(0 - oco -co Lot No.t_
Site Plan Name: -T- Block No. c1
Project Name: 1'Q
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
QVMove JJX \S f-0 C)
Cc6i , t r act Yew P� S v�o�. nck,-, S A t"t'zcl C3 k-} ro C)
Arco CCAS PLL QLk g 2. 5
CONSTRUCTION INFORMATION:
Additional work toe performed under this permit-c ec a appy:
[]❑HVAC n Gas Tank ❑Gas Piping, Shutters ❑Windows/Doors
❑Electric- ❑``Plumb;irig•. ❑Sprinklers ❑Generator=' Roof
Total Sq:Ft of Construction: (i S : Ft. of First Floor.:
Cost of Construction:$ 2,:�,i Utilities. Sewer❑Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Name: �IhQX�bRQJCX-G�
Address: 1✓ Company: .f� Tel.•
City: ' W-bi Stater Address: '1 Ul )
Zip Code: F�ayx: City:-eX'O(�(IACk1 State:,
Phone No.
Zip Code: 3q3Z(:tD71 Fax:
E-Mail: Phone No. 1712'31 - d
Fill in fee simple Title Holder on next page(if different E-Mail: SonIR(,'�) keCclotA oo m . com
from the Owner listed above) State or County License: CC C 13 1-0G 00
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: muel ro,+ Name:
Address:_ T1 Address:
City: r��pj�Y12 QI State: City: State:
Zip: 31..3d��0� Phone: �o ' 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 KNection. If you intend to obtain financing, consult with lender or ana ney before
commencingWork/or recordingur Notice of Commencement.
-",,& I _"Vialk V4 s
_Signature of Owner/Lessee/Agent Sign at Contractor/Lice older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing inst u nt wa acknowledged before me The for oing instrument was acknowledged before me
this�day of 20�by this3QdayofU&M—If-A 20VtJ_by
(Name of person acknowle iYP� me of person ackno ag. `
. - :�� . SONIA ®ESTAFN P IA DESTAFNEY
#FF125 20
MY COMMISSION °
MY COMMISSION#FF125420
EXPIRES May , 2018
21� 2 �;, oa' EXPIRES May 21.
Fil
i at re o to ublic- natur of ry u a o
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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