HomeMy WebLinkAboutBuilding Permit Application All APPLICABLEIINFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
■
RECEIVED
Building Permit Application'UN 10 2016
Planning and evelopment Services
Building and C de Regulation Division
2300 Virginia, venue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR:
Address: ,) 0 C-Vau 1W i Q Ln
, 4 J
Legal Description: Tv\twt oalfS EJ-5r �S -LQ+Ce ( 0-3 1 AO(pr Diaz- 115(aR
Property Tax III)ft:. 3)�O Y- 9v /- 00 0 le -00cizI Lot No. Ly
Site Plan Na�e:. Block No. W/A
Project Nam l: )Nim 1)n vfy)
Setbacks F ont Back: Right Side: Left Side:
1-tSWJI like 6- like -�AAIrdnz door Z
A clitional orkto-bape–ft—rmed under t4i-s permit---cbeck all that apply:
—Mechinical —Gas Tank Gas Piping Shutters /Windows/Doors
Electric —Plumbing Sprinklers GeneratorRoof
Total Sq. Ft f Construction: Sq. Ft.of First Floor:
Cost OtLonttruction:$ Utilities: —Sewer _Septic Building Height:
Name- x OnNenwr
Name: rmfw
Address: 2510 CIMIJ-ruy f!J I Company: Mal EVA is-e � &evaj dhaL�Awv
City: State: FL, Address:J108 -roe"ahau)le 'D/
Zip Code:!Ml I Fax: At A city: IndidA 44.rbour l3each. State: Ff
Phone No Zip Code: 32A37 Fax: 32-1-777- W3 q
E-Mail: Phone No. 772-337-11q70
Fill in fee simple Title Holder on next page if different E-Mail:
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from the Owner listed above) State or County License:
If value of instruction is 2500 or more,a RECORDED Notice of Commencement is required.
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'0, -`70
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: I State: City: State:
Zip: I Phone: Zip: Phone:
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FEE SIMPLEITITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: I Name:
Address: I Address:
City: City:
Zip: ( Phone: Zip: Phone:
1 certify that I o 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 str ctures,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 they first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recordin our Notice of Commencement.
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_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OFIFLORIDA STATE OF FLORIDA
COUNTY OF VCUrd COUNTY OF 'fJ:eyl t-
The f�orgof Ig instru ent was acknowledged before me The forgoing instr ment was acknowledged before me
this I day of Jur 20 lby this —1 day of s) 20 1(p by
(Name o i rso dging) (Name of a 1 ging)
(Si at r I a -State of Florida) (Si of lic-State of Florida)
Perso all 11 OR Produced Identification Personal OR Produced Identification
Type o enti Produced Type of Identi ication Produced
�� BROOKESZ3
Commissi n No.W244i0S$ ) S' om sion No.i tl4tc6s- z6'`�' eal 8;00—KE5Zla1<fl
It,, MY COMMISSION b FF COMMISSION N FF 2440
EXPIRES:June 25, 019 +; 1~ EXPIRES:June 25,20ts
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
I COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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