HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLEINFOMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: C9 ' Permit Number: 0 0 ()
Building Permit Application RECEIVED
Planning and Development Services 096
Building and Code Regulation Division JUN B�. 2 6 f�
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
ERVIT-APPLICATION-FOR: To Select from dropbox, click arrow at the end of line
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Address: qLtD5 V'%re-bCXr-K QV% -9---t-• i 2r05 ��f-L '34q'51
Legal Description:M pn +e ca-V-10 CO l l_nAy q GJ L t b Lkn\ - Onc-LO"F' l pS
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Property Tax ID#: 13a"1-$O lam—�Ot�-� Lot No. Ila?.
Site Plan Name: of F 1 J-Y0.Y1 Block No.
Project-Name:
Setbacks Front Back: Right Side: Left Side:
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Additional work to bfIrtormed uncierthis permit-c ec a app y:
HVAC Gas Tank ❑Gas Piping _Shutters Windows DoorsY
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Electric ❑_Plumbing OSprinklers Generator Roof
Total Sq. Ft of Construction: S . Ft. of First Floor:
00
Cost of Construction:$ a`1"l 5 Utilities: _Sewer Septic Building Height:
Name f:;-ClOLP-5 K4•Wot-p Name: i lVA
Address:9 405 ?IhebCXr K C7t • Company: _TY_f-_ POC-C-" 1�7CkO-v
City: �-:Dr4- 1 ic-rCe State:'CLL Address:I 35kD CMMIn_ C%Q\ 0-i C -urll{.LAO
Zip Code: 3gol51 Fax: City: iU<'l y1C oz_ t State:FL
Phone No. Yl�- 8�2-G 73'�] Zip Code: -145 Fax:-71ZLIU 5 3252
E-Mail: Phone IVo.�1�-�IOFJ �u112
Fill in fee simple Title Holder on next page (if different E-Mail: )Adnt%o@ i\-"-_ OCCh ackbq-COM
from the Owner listed above) State or County License: C 13C %2 SFS'A SQ
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:SiarCOCaS} Y�cch� 6no, L_LC Name:
Address:�3b3o 55'�S Address:
City: OgnocWoA Cc State: IF L City: State:
Zip:INILob Phone- XI-53Z-8000 Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zi Phone: ZiD: 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 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.
A A s
6TAture Owner/Lessee/Agent Signat re o ontractor/License Holder
F FLORIDA q , .p ATE OF FLORIDATY OF COUNTY OF
The forgoing ins ment was acknowledged before me The forgoing instr ent was acknowledged before me
this 1ST day of 201�by this�day of 20 l(o by
(Name of person acknowledging) (Name of.person acknowledging)
(Si nature of Notary Public-State of F ida) (Signature of Notary Public-State of Florida
Personally Known OR Produced Identification Personally Known_ S,4 OR Produced Identification
Type of Identificatiofi Produced Type of Identificatior5 Produced
Commission No. (Seal) ComRENDA iQAPI BOON I�
Commission#FF 907848
rUrW ?t •i
—0 i0AN
vB�°' FF 907848 9 r
August 06 2019
Re ommission Efcpires
b!R
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS