HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 �7
Date: �3 1� Permit Number:
RECEIV7D JUN 3 2016
Building Perhiit 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
-PERMIT-APPLICA : To Select from dropbox, click arrow at the end of line
4
Address:_39V(0 Shores,de ®r i. FF• VerC FL 349�}q
Legal Description: TCXKVZ(o V-VCXAS Sub6%ylst on L99p Lp9-2`i, Uzo+ 14
br 37$Lt -S 6)
PropertyTaxlD#:Ni-} 23-56to- 001 "1 -0oo-3 Lot No.
Site Plan Name: (_'aDu-k> Block No.
Project Name: CCkt2L-t-tiy
Setbacks Front Back: Right Side: Left Side:
rj C r-e_eX-% k o CCN e_'-2.6 ?ox-CV-1 Off tfx 2X1 S'1� ..:SLAB
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rtiona wor to e e orme unert is permit-c ec a app y:
HVAC �Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric ❑Plumbing OSprinklers 11 Generator F] Roof
Total Sq. Ft of Construction: l O l S SFt. of First Floor:
oe
Cost of Construction:$ 1 t k 15 Utilities: _Sewer[]Septic 'Building Height:
Of1l�E ��L ES�EI � y f^ e x ?y oY 5 2
Name 90beIr-k '•"C�leXe SGi Ca?"- C> Name:
Address: 3Q1110 Sht3re.SieAe Dr• Company:
City: F•IG7% ce State: FL Address:-7351 CMmecC:\cal Qi C •U,61t►-10
Zip Code: ; -tG14q Fax: City: �O ly1L'wt State:FL
Phone No. "1-12-Shc GEI to • Zip Code: Vj_1gS1 Fax:-7`7214Uo 5 32S2
E-Mail: Phone
Fill in fee simple Title Holder on next page (if different E-Mail: \otckyyi%(1@ i\xO) k�ytCkON-Corn
from the Owner listed above) State or County License: C 13C %-L S s y Sq
- 115 $
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:�UnCOCaS� �cch� Enq LLC Name:
Address: �3to3o 5is'hS .Address:
City:QQeQc' e.0 State: IF\- City: State:
Zip:331106 Phone 1D.1-53Z-8000 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
coMFn-eKing work or recording our Notice of Commencement.
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4ignatur of Owner/Lessee/Agent S' natur of Contractor/License Holder
AT F FLORIDA -p E OF FLORI�q, ��J
CO NTY OF ,lc f,c� COUNTY OF "D,
The forgoing instru ent was acknowledged before me The forgoing instru ent was acknowledged before me
this�day of 20 lI(o by this ft) day of 20 1 (o by
�[�,YVIe R fti�CL.n rl V Q-(YIPS (t�f?3t"�h r�
(Name of person acknowledging) (Name of.person acknowledging)
bILAk-t"A QQW ktu_
(Signature of Nota Public-State of Flo a) (Si ature of Notaryub' -State of Flori a
Personally Known�OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. "�:�; g A JOAN ROO mission No. � OAN ROONE
Commission AFF 90784 9* ;'a Commission#FF 907848
.: M°;,R� August 06, 2019 "'4�un �"� August 06, 2019Revised 07/15/201:4:t
REVIEWS FRONT ZONINGSUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS