HomeMy WebLinkAboutBuilding Permit Application with attachmentsDam.
Plani7ing and Dew1opment sen&es
Building and Code Regulation Division
Permit Number-
Building Per
'it Application
zjc►u vlrglnm Avenue, ►-8rt Pierce FL 3498
Phone: (77Z) 462-1553 Fax: (77z) 462-1578 Commercial � _ Residential � -----
--IT APPLICATION FOR&TvSetectfm dn4box, dick amaw at the end of line , -
PROPOSED IMPROVEMENT LOCATION:
Address: of,
Legal Description: VLVU- partp&_ ckvL(4
Property Tax ID #:
Site Plan Name: t
Project Name: 1)(CAA..,
Lot No. [ �
-
Bkdrz No.
70
Setbacks Front Bads: _ Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
105�-A It I;iYayIioict � ,���10114 G —
and 1��� rd �itil J
44- ton co,.rvrfc�T'� y to reds ccv/I.er1 0� fi�tC I-IOuk,
q �vea.r pr�-�j i d1a
, q« -I -es- IKy►-atl 1P '14 �oo�� �c hu.
a,la�y rig1+k Yo er Lit • _ _
CONSTRUCTION INFORMATION:
I - - . "Ns- 0 I'MI
Additional work to b,Ie_Qe� .,rtorrtuntler this permit —check a ly:
app
HVAC LJ Gas Tank Gas Piping � Shutters � Windows/Doors
, Electric Ll Plumbing Sprinklers �'Generator Roof
Total Sq. Ft of Construction: _ SQ. Ft. of First floore
Cost of Construction: $ � � � ' y" _ Utilities:'_�SewerSeptic Building Height:L
OWNER/LESSEE:
IN
Name -- - - Name: rp✓taW1 L (fit _ u 6k.I �- --
Address: "iD�u-sYl GQ [`F _ _ Company..
T
City: PK L-IState: Address: ' dlb a AV
Zip Code: 3q, 5,? -Fax: _. citY: �,'�L _ ,_State:. �L
_ ry X'
Phone No. �y � 3 yN7 . _ Zip Code: 3tl9h 3 _ F ax:
E -Mail: �.Y� _ Phone No. �F, J
FIN in fee Am* Tide Molder on next pass ('rf different E -Mail: L�YYI OP£f @ rN d I
from tfm Owner listed above] I State or County License: .2
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SUPPLEMENTAL CONSTRU ION LIEN LAW INFORMATION110
ESIGNERfENGINEER: Not Applicable MORTGAGE COMPANY:
Name: Name: I OIL
Address: Address:
State: city:
cityb
Phone:
Zip: Zipa
Phone,
BONDI NG'COMPANY:
JPFF IUMPUF TITLI HOLDER: Not Aorflicable
Name:
Name: t.L8 — I.- 1_� _.
1. IL
Address:
Address:
r"+
LRY: I y W I __ - — 11� _. --- -- I
Z" Phone.
Zip: Phone: 1P.,
Not Applicable
Statem.
Not Applicable
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County, makes no rep resentation that is granting a pe t wfli authorize the ermit holder to build the subject structure
fat rMi covenants that may -restrict or prohibit such
which is in conflict with any applicable Home Owners Assoc ion rules., bylaws oranN
structure. Please consult with your Home Owners Association and review your deed for any restrictions wh ch may apply.
I w0l, in all respects, perform the work
In consideration of the granting of this requested permft, I do hereby agree that I
ns, the Florida Building Codes and St. Lucie County Amendments.
in accordance with the approved pla
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 Pasted on the jobsite
before the first 'inspection. If Vou intend to obtain ffnancing, conSult with lender or an attorney before
tice of CO nt.
COUYK93e.ncing work __or_-,,reco.r i_ngyour N.o mmen3DA�
-,-,Signature of Owner/ LAQ�ent
STATE OF FLORIDA
COUNTY OF
in tMent was acknowledged before me
The f F ac,
" ;Wi ng st
this ,,or k day of Aby
(Name of person ackno ledging
ta
tgnatur NO
Personally Known
Type & Identificati
Commission No.
Public- State of Florida
Re'611sed 07/15/2014
I I I " 111111— 1
OR Produco Identification _-I
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MAHTAM'i MAI 1t:V
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State of Florida
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Nota(Y P C
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am M X i ks Apr I Z, 2017
P
-19074
Comrnission EE 8
�I'l-NdiMTO-NUidl _Aibgr
REVI EWS FRONT ZONING
COUNTER REVIEW
DATE
COMPLETE
IN ITIALS
Signature of Contraktor/Licen er
77�
STATE OF FLORIDA ca
COUNTY OF
The forgoing instru ent was acknowledged before me
this day of ,L_'d606wL 20 by
A�
Name . of person dc1nowledIging)
A
(qicyn:;hjre
- I m.i. vo.
blic- State of Florida )
Personally Known OR Produced Identification .1. S.O/
Type of Identifi a '0 Produced p
P YAlv N
Commission N
Oda
PublIc - Slate of Flor
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MY COMM, Expires Apr 12,210171
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Borded Thwxqh.N'3,11una,1 Not
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PLANS VEGETATION
SUPERVISOR
REVIEW REVIEW REVIEW
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