HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: J ' 1q . ItoPermit Number: X05II
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Building Permit Application MAY 19 2016
Planning and Development Services Si. PER;vil?71iiIC
Lucie County, FL
and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X,
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
SED-,! RPyE TrLOCATION
Address: 3 r- M
Legal Description: Vtr f ( I �J pqe-(- -7: p q6' 77
3 LIP -2r
Property Tax ID#: //- _L 'G'Yx��)C)o- ( Lot No.
Site Plan Name: Block No.J
Project Name: �?_p Y
Setbacks Front Back: Right Side: Left Side:
DE1`AIlE� D�SCRIP`f10N -
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frig'' r 't rp{wc 7r.+ iS:s tk r e •.gxef i•r:r H r, - N y 1. ,{*n1;'..
CONSTRUCTION INFORMATION
.Additional work toe ,e orme .,
under this permit-c ec a appy:
❑HVAC 0 Gas Tank as Piping _Shutters Windows/Doors
OElectric F]Plumbing Sprinklers FI Generator Roof
Total Sq. Ft of Construction: 34.-20 S nSewer
of First Floor:
Cost of Construction:$ �' �( ovUtilities: [:jSeptic Building Height: �S
OWNER/LESSEE °` r ''r CONTRACTOR. s`
- .,w
Name kkCL4h 4o v-) Name:_"T (aS E
Addres : Cw 4oi, Company: Yt C
City: �-D G✓qe'_ State: Address:�!)5y( �i- (a 444 r Sf-
Zip Code: 0-7.a-7/ Fax: City:�� Stater_
Phone No. q7 -76?74 Zip Code: 34WI Fax:—/-?c9��-7-X-3
E-Mail: Phone No.�7o? 09-7 Q(?
Fill in fee simple Title Holder on next page(if different E-Mail: bLQW ccz? C KeJ ' U
from the Owner listed above) State or County License: QfC E72Q(9S_3C-(
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LI`EN.LAW INFORMATION. -
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 buildingpermit 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.
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_Sig ure of Owner/Lessee/ ent Signa re of Contra r/License Holder
STATE OF FLORIDA" STATE OF FLORI��Il��►
COUNTY OF NISyl COUNTY OF
The fo oing instrument w acknowledged efore me The forgoing instrument was acknowledged before me
this day of 20 ] by this J-7 day of20 ,LL by
(N ,..;af-person,acknowle,.ging} (Name of. son:acknowledaine 1.
(Signatu a of Notary Public-State)of FI ri a} (Sign4ture of Notary Public-20aa of Florida)
Personally Known -.-._-_.__..OR Produced Ide tification ..- Personally Known OR Produced Identification
Type of Identification PFoduced /*J, "-"`'"' Type of Identification Produced
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�8�13C4 CA I '�.. F <<
Commission No. �° a Commission No.EE'a-71-3 l�j
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REVIEWS FRONT ZONII�I�e�'°Ue�� t bR PLANS VEGETATION SEA,YL�R.JT0n .j< ROVE
COUNTER REVIEW�''�°p°Ali �ilf1 W REVIEW REVIEW REVI;� ,STAS � IEW
DATE
17 COMPLETE
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