HomeMy WebLinkAboutBuilding Permit Application ALL APLICAB E INF MU TBE COMPLETED FOR APPLICATION TO BE ACCEPTED Cl R
Date: I Permit Number: 6 ��
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Building Permit Application
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 V
PERMIT APPLICATION FOR: L�
:PROPOSED IMPROVEMENT LOCATION
Address: b�50 0 LAS PAQVJ
Legal Description- I.AS ?,4 L41ALdl -7 Dr_ 26N —55-1
S�C./Ib"r�
Property Tax ID#: LA 15; - "S D� —boil _'001)_ 0 Lot No.
Site Plan Name: Block No.
Project Name:. fenc_v .
r .
Setbacks Front Back: Right Side: Left Side:
11,'DETAILEDDESCRIPTION QF WORK
INSIxILL. Npr1grIbr TAvl't C-c, (?cAyf r) ,4?/A
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CONSTRUCTION INFORIVipTION
Additional work to be nertormed under this permit-check all appy:
HVAC Gas Tank ❑Gas Piping Shutters Q Windows/Doors
nElectric 0 Plumbing ❑Sprinklers OGenerator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ '7 D, Utilities: Sewer D Septic Building Height:
OWNER/LESSEE CONTRACTOR
Name L� Name:
Address: -5'� INJ�JA-/J P-Nt7e- T)2 Company. rr��. /�`�� L�o�s _2;t
City: PV2T AL--YaCL- State:?=l- Address: ..�2'90 ;6_;
Zip Code: 3`f� 5 Fax: City: . 'X: -erg State:/11�
Phone No. 2 of ~ I I '�-9 Zip Code: '3 Y 9V?' Fax:
E-Mail: U,la-f-i 6v S @•be 1 I SG"+/w ki of Phone No. 7Z2-,2-/6-/30F
Fill in fee simple Title Holder on next page(if different E-Mail: 1 P l-A,
from the Owner listed above) State or County License: G Cr-
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN 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 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
commenci k or feciprWrig yourA-0ce of Commencement.
Y
s
_Signatur f Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF _5�k COUNTY OF C l
The forgoing instrument was acknowledged before me The fling instrum nt was acknowledged fo
ere me
this Z day of 3L n� 20 L6-by this day of y
Srp
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signat o ryPub ic- tate of Florida)"
Personally Known AOR Produced Identification Personally r duced Identification
Type of Identification Produced ype a i o ,Producedeaa
Y'4 Notary Public-State,gf Fla r�da
Commission No. EC Z�b ;•••.4�(SeaLOGELAR.HELSErH Commissio ,. Commission#FFI»J b
MY COMMISSION t EE 200139 I %''Fp�O• MY Comm.Expires May 27 2019
EXPI % Bonded through
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS