HomeMy WebLinkAboutBuilding Permit Application 15iiQa=t-I Ina,6J )
10 J
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED U
Date: & I KIP Permit Number:
RECEIV7D JUN 2 0 2016
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: To Select from dropbox, click arrow at the and of line ki\J C.
R:
'-INS
]i!
Address: &0E LIP Ytil I of
Legal Description: U (.h
Property Tax ID#: �,��-- �a��^ ':z1—r_>60-2 Lot No._ 2�4 _
Site Plan Name: Block No,
Project Name:
Setbacks Front Back: Right Side: ,_Left Side:
Af -ULA4 L i lk, ... OYW
v
na work to rtormed under this perm -checK all appy:
HVAC
Gas Tank E]GasPiping Shutters Windows/Doors
Electric 0 Plumbing Sprinklers [_Generator Roof
Total Sq.Ft of Construction: I-q(I So.Ft.of First Floor:
Cost of Construction:$ � �� Utilities:11 Sewer Septic Building Height:
tri':•• :�. 'r1.
SYR
Name Name:
Addres : Company:
City: t State:,, Address: _gym o
y� dA� aas�samt>@ Pi�C
Jar�u�ro
Zip Code• Fax: City: t I unl ,EL.34986 State:
Phone Na, .y" Zip Code: Fax:
E-Mail: Phone No. �-
FIIl In fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
if value of construction is$2500 or more,a RECORDED Notice of CommenceMent Is required.
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State, City: State:
Zip: Phone: Zip: Phone: ---_
FEE SIMPLE TITLE HOLDER: -_ Not Applicable BONDING COMPANY; —Not Applicable
Name; Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie Count mak no represent tion that is granting a permit will authorize the permit holder to build the subject structure
which is In conflict
with any appllcab�e Home Owners Assocrnon rules,bylaws or an covenants that may re$trtct 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 fallure to Record a Notice of Commencement may result in your paying tvilce for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If y 4ntend to obtainjinancing,consult with lender or an attorney before
commencln work or rec our ice o mencement.
$l at ner/Agent/ s Sig ntractor/ ice er
A7E OF FLORID A7E OF FLORIDA
COUNTY OF COUNTY OF
The r ng Inst meet was acknowledged before me The forgoing Instr ent was acknowledged before me
this�Y of 20 1 by this;' ay of 26_Ib by
-\-f n V1 PAL -40 vWkY1L-Ubnne-�e. �6(y�d
(Nam of person acknowledging) (Name bf person acknowledging)
I Ant,4D �b M Q, V1 K
Sign ure of Notary ubl ate of Iorida-) (Signatu a of Nota:2::roduced
to of Florida)
Per nall Known OR Produced Identification Personally Known Identification
Y
T e of Identification Produced Type of identification Pro d
Commission No. ,zt<. N AMILTON'
Commission No. aY ss ry9assaa
LYNNETTEHAMILTON :Jror, o
MY C0141013ION r P794UN
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIAL5