HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ,5'' 9' I Ip Permit Number: I Leo D
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Building Permit Application MAY 17 2016
Planning and Development Services PER:4lITTiNG
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.[M ROVEMENT LOCATION
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Address: i77s0 00,1EA'N Dnawe -�-- <<J3 �� 1SERl
Legal Description: %$1-ANO _:bVdeS CorvrJu A- VN t-r 1133 A'/4.1 A-
AQ a taAi- 0o Lan 369 - I - 1
Property Tax ID#: 35-1S (001 - Oa S-7 —t�00 - I Lot No.
Site Plan Name: J�INC / Block No.
Project Name:
Setbacks Front Back: tJJA_ Right Side: N A-- Left Side: A/
DETAILED DESCRIPTION OF WORK . :,..
6()eNiiV(,,,CL., M 5J4()r MS)
CONSTRUCTION"1NFORMATION
Additional work toe e Orme under this permit-check a appy:
HVAC F]Gas Tank []Gas Piping _Shutters Windows/Doors
Electric ElPlumbing115prinklers ❑Generator _Roof
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ y�b0 ' Utilities:cn Sewer O Septic Building Height:
Ow.wR/LESSEE CONTRACTOR
Name Drmc 1 Name: 1C41'!-�u C'xidaal�a�1
Address:-72-5— c5 tJULI_ L-AW-+r" kL- Company: iN
City: %C_*.A-r V State:M_V Address: OW AW
Zip Code: L(9 oTIB Fax: City: State:
Phone No.C2,c.q -77 Zip Code: 34 9;'J Fax: ( -012-q' u y
E-Mail: Phone No. "1-72 (,9IZ—coon,u
Fill in fee simple Title Holder on next page(if different E-Mail: �Cd -t'i� jajVL C.Ac^
from the Owner listed above) State or County License: Gc. I
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATI,ON:,`
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 fAureA0 Record a Notice of Commenceownt may result in your paying twice for
improvements to yFrej/di
Y.erVoticeof
ice of Commencemyent.
t e r riled��Zl
on the jobsite
before t f st insd to obtain financinsu i le eney before
comm cin rk Commence
G�^'T
G'
S
igna a of Owner/Les Agen Signature of Contracto
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF .ST I Vr COUNTY OF —S;;—
The
S%The forgoo' g instrument was acknowledged before me The forgo�i g instrument was acknowledged before me
this/ of_ /�� 20/�,/ by thi-5,�_"vWY of__ Al��X 20 ZZ by
(Name of person acknowledging) (Name of person acknowledging)
(Signatu of Notary Public-State of Florida) (Signatu f-Notary Pub/tc-State of Florida)
Personally Known_ OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. ''••, fi4Sh9AUMOND Commission No.
MY COMMISSION H FF 113907 •, ANN M.GAUMOND
r. EXPIRES:December 7,2018 =q' �:
MY COMMISSION#FF 171.
f" A EXPIRES:December 7,2018
Revised 07/15/2014
pq ' Bonded Thru Notary Public Underwriters
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS