HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLEt INFO
MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
I
RECEIVED
Building Permit Application MAY 2 5 2016
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT Alf PLICATION FOR: To Select from dropbox, click arrow at the end of line
1
PROPOSED IMPROVEMENT LOCATION:
Address: 1110 sE (Gkp?f C*. ?ba 54- (4c.ie R_ 34983
Legal Description: _iF erl ev/ec 31, 3 Lok- G. / j4o sE C4<rPr cam" �,orA7 sk Ljo5, Fc - SdyY?
� )
Property Tax i D#:_ }40 5E pAVer �. VC,(-l- _S+- LuU'c, F(- 34997 Lot No. G
Site Plan Name: VfW Block No. 3
Project Name: &1(4
Setbacks Font Back: Right Side: Left Side:
DETAILED,'DESCRIPTION OF-WORK:
RervrouL ��xcsi�n� -b1e- Yixiij S-t � j lnt�l1 9655 5V came vmeA,_-\ fbo6n5 sus_4c
Ofte-
CONSTRUCTION,INFORMATION:
Additionalworkto ,e erformed under this permit-check all appy:
HVAC Gas Tank ❑Gas Piping Shutters E]Windows/Doors
CGenerator
Electric Plumbing Sprinklers JERoof
Total Sq. Ft Jf Construction: 6 o0(0 S . Ft.of First Floor:
Cost of Construction: $ a�,[�l� Utilities:�Sewer OSeptic Building Height: 1 S�
OWNER/L`ESSEE - CONTRACTOR:
Name_+tiaoGre+- % 6z[,u5 cfo-) Name: f_,cGr" Ua(tl
Address: i4o S6e,veVC+- Company: E1,.4c- 9,6oi:�!2� solukjovls mc-
City: 'Pork s+ lucre State: Address: 6;z se"c,�hco%, mac.
Zip Code: 3gyg3 Fax: ?az-znS oz:?-5l City: 54vo,(- State: C-
Phone No. 403-7401 Zip Code: 3499N Fax: Fez- zI•y-o2�g
E-Mail: Phone No. --q,,_,4o-)-74Q 1
Fill in fee simple Title Holder on next page (if different E-Mail:_et,: ,ro�ren Got• c��,
from the Owner listed above) State or County License: -fcr- c1?3o33?
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LEEN LAW INFORMATION!,
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: I State: City: State:
Zip: Phone: Zip: Phone:
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FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: I Address:
City: City:
Zip: Phone: Zip: Phone:
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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 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
commencing work or recording our Notice of Commencement.
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s
Ignature oflown essee/Agent Sig6ature of Contr nse Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF K&,/-h h COUNTY OF p,/ea� bV1
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 6 day of MCI 20 LC by this_L� day of YYl ay 20 IC_by
, rwa,o Lrro, a7= C--� lx.,cc-,
(Name of person acknowledging) (Name of person acknowledging)
A2Z
(Signature of'Notary Public-State of Florida) (Signature of Wotary Public-State of Florida)
Personally KnownOR Produced Identification Personally Known OR Produced Identification
Type of Identi icatio Produced Type of Identificat on Produced
Commission o. b 2qyA 'ssion No.g-061-1 Lti
{:•eva�. THERESA DE RIT y THERESA DE RITA
_' MY COMMISSION#FF 002929
a* *=
:* MY COMMISSION#FF 062929
;,qf6` Bonded Thru Notary Public Underwr_'niers �;•.,,,.•P
EXPIRES:October 29,2017
of N°.• Bonded Thru Notary Public Underwriters
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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