HomeMy WebLinkAboutBuilding Permit Application 05/17/2016 13:15 4073702539 ELECTRICAL PETROLEUM PAGE 01/03
ALL AP i INFO MUST'8E COMPLETED FOR APPLICATION TO BE ACCEPTED ��
pate:
J7 J
le Permit Number: /
r
Building Permit Application �E�EI%jFD
Planning and Development Services
Building an�Code Regulation Division J AI
2300 Virginia Avenue,Fort Pierce FL 34982 XPhone:(772}462-1553 Fax:(772)462-x.578 Commercial� Residential
I ,
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address:
Legal Description:
Property Tax ID#1: LA k(A~ S� �l� y G Lot No. _
I IBlock No.
Site Plan Name:
i
Project Name:
Setbacks Front Back: .-Right Side:��Left Side:
.. •• _ 7.75'2?;17" J.;;sem=:"
•w„1:":,<•' ?:S• i1:`
- .� ,.r,., rti�� :i�;�-':`;G,,. ^ .u��,A.;4,v.;q' ''t;- .-.,? .r.. ,a•}ri•.i;}'�k 7:A:�7a^:`�:::•;:t,.,
"•7Yi:.•• .:r`.✓.• .i �; >.' :a.. :,..; ;':r:�• :.,.,.,s �r;lp4;••..w,.. .`•.,..rl'{{'!'v'f.. '.,f,',";�,1..N:r J:f':=„t{!r �^;`.Y• k .,,� r..v:r�,r�,.
�:� - :��j ' '.: � 1� �L�:” :.y y '•'x4:.i:.,,A+ J �..w,:�it' ,F.. J'_<. '}ra 4K r.��.�.:v,'�Y:'
;.,,�'�.rn"�i.••.►:�i�l '�� "7/'T..'44 yLy�.�►{v' ycr"�r� ::i 1.F a�•':k,•,••,' .4•:r�;,,J{'• .ip:.;v.;.w`},t,.. fie,�'., r...
:.'',":.,:�.,wt .y.�.,a;; ..:.: t'L ter'..:a7:.'i:=�r.i .�i,.•...y,,
::4, �• Kir :,.,l i. ,'� M,
.. .. "..g:..,.: ...,.,,..'..•.,•.-..$w r:+.'t:; i,:Jp• �.iC;: ;:k��:�,t,t•P J�},,*�r�G::,i W
•,.�,...,., ",C • '.,.f'•' •.t , ., ;i.!•4.: t1.•�:•`•. ,+v,:•?ted: „a..•,�- �ir'� .:•2-;•i;:•'Iy
i, ...��::..,:,•:•a ./.'.?"r.:i�"' :=3i.: "•'•>''•r 1'�lC��._:> y.ay�:;::f•...w s;:�.'":5.� :,�;+`:ia•7:' ;">'r ,.2..:.,;.;•..
owl
4,
Sty[
r`:::'' :. �:a;;;-f"
I Iona wor to Orme un er is perms ,t e app y:
MVAC Gas an []Gas Piping Shutters 1__I Windows/Doors
lectrlc Plumbing
OSprinkiers Generator Roof
Total Sq.Ft of Construction: SQ.Pt.of First Floor"
of $ p �� -—— Utilities:�Sewer[,_Septic Building Height:
Costo ,
`iiJ:'±•iY) "P'rPt,�`:4• ht;ti-��"?t��'��';ri•.Y' .,Y�•:li;;��j�ry'r'�%. _ !�. 1t.:�:;�,�,%r(�'.%;�'F�
Name d
ACom
pang:
ddress: � �
State: Address: 'e
ci y Fax. City: C •'� State: (--�
Zip Code: Fax-467-
o. ( -7 S'
�Z
Phon NZip Code:
Phone No.
Fill In fee simple Title Holder on next page(If different E-Mail: e'
from,the Owner listed ahove) State or County License:
If valde of construction is$2S0Q or more,a RECORDED Notice of Commencement is required.
I
i
05/17/2016 13:29 4073702539 ELECTRICAL PETROLEUM PAGE 02/03
N,
"A
DESIGNER/ENGINEER: Not Applicable MORTGA69 COMPANY: T Not Applicable
Name: Name:
Address: Address:
City: I State: City:
Zip* I 'Phone: Zip: Phone:
FEE SIMPLEITnU HOLDER:
Not Applicable BONDING COMPANY: __Not Applicable
Name: Name:
Address, i Address:
City; , I City:
Zip-1 Phone: Zip- Phone:
I certify that no work or installation has commenced prior to the Issuance of a permit.
St.Lucia count tv makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which Is in coifflict with ariapplicable Home Owners Association rules,bylaws or a covenarits that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed any restrictions which may apply.
in consideratioI
n 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.Lucia County Amendments.
The following I building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures, ,fences,walls,signs,screen rooms and accessory uses-to another non-residential use
00
WARNING IT R:Your T"ure to Record a Notice of Commence nt may ult in your paying twice for
in
e
'5 ;fM
pertk A Not of C �e re
improvements to our pro Commencement mi be.1 cord and posted on the jobsite
I s
before the jfirst i spection. If L Int to obtain financing,co suit with len er ttorney before
commencing w rk or recon!V- v�Nott
rEtice of Commencemen .
signature if Owner/LeyCe/Agent Tisnature of or/Ucense Kolder
010' ContrRI D
STATE OF FLORIDA STATE OF F
COUNTY OF (Mana— COUNTY OF ck
V
The for oing instrument was acknowledged before me The forgoing instru n was acknowledged before me
this day of 20L(L_by this J__�day of 20 L(O—by
his da Df 7
L D
nstru L
�b f n rwrkr
I� ,
edging
En y
(Name of pieson ack edgin (Dame ofpermsonatd_3 owle Ing)
(Signature'of Notary Public-Sixt of Florida) (Signature of NotaPubJ11'c,4taXe of Florida
-,t
personally Known I— ORPro personally Known 09 Produced Identification
gusce4ggg cation Produc
Type of Identification Prod relof Ide.ntifil ALEXANDER E. JAMS
commission#FF 51778 m issio mission#FF 6177
commissio�No. I&OOmmission Expires No. fM LCIA ST(S"Ip . . ire
October 10, 2017 g My commission txo
October 10, 2017
Revised�07/15/2014
Kk:VftWb FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW, REVIEW
DATE
COMPLETE
INITIALS