HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: / Permit Number:
1TRECEIVED
Building Permit Applicati
4� v 2096
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 APPLICATION FOR:
.P.
8,
MIN
Address: 5600 Deer Ruri Ori\Je Eo4 PierC69 i=Lai& 3 q951
Legal Description:
Property Tax ID#: 1313 - 50a - 06) 60 - 006 - 3 Lot No. VA 3
Site Plan Name: Block No.
I
Project Name:
Setbacks Front Back: Right Side: Left Side:
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DETAILED D�SCRIP�T(QN OF WORKr �� a v ti Y ~ 4
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Additional Work to be pertormed under this permit-check all that appy:
Mechanical Gas Tank Gas Piping Shutters Windows/Doors
—Electric _Plumbing —Sprinklers Generator —Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 4; 1;0,00 Utilities: —Sewer —Septic Building Height:
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'd RIX E. CQNTRAGOR E ,
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Name ��;� G t,{oT�,. Name: T.!55ac
Address: ne� Ruou Company: =i,eei C-�c.dc�s�. c�ccrz
City: 14 19i-PI ce- State: l Address: q4g,ct Ai cv RJ rW4cC4� </L/C-)
Zip Code: � 3 y9 Sl Fax: City: A-1- State:
Phone No.' ?'1�_ Z`Id Zip Code: 3LIQ 1;4 Fax:
E-Mail: Phone No -7722,-�sz�= �'zif
Fill in fee simple Title Holder on next page(if different E-Mail D: CS aae_ Ana,, 6w.* F eem
from the Owner listed above) State or County License
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
',SUPPLEMENT"ALCONS� RUCTIOh1V LIEN�aL'AW IN�FQRMATION` &` h h � 1r f�°
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
__._Name: N
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:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do.the work and installation as indicated.
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
commencing work or recording our Notice of Commencement.
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Signature of Owner/Lessee/Contrac or as Agentt - Signature of Contractor/License Holder
aLL�n Y `m a
STATE OF FLORIDA z 2 = STATE OF FLORIDA r m Cn
COUNTY OF COUNTY OF
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The forgoing instru n as acknowledged be fo @@X The forgoing instr t was acknowledge be Pepe
this / day of 20/( by MW this day of 20/6 b
S 'eo
i.0/ aYY
411
(Name of person acknowledging) "'r,'„9;t'' (Name of person acknowledging)
31
(Signature of Not Public-State of Florida U ,Signature of o a y Public-State of FlorictA)
Personally Kn, OR Produced Identification Personally Known OR Produced Identification
Type of Identifica nn /� /� Type of Id ica 'on
Produced U�J � Produced
Commission No (Seal) Commission o. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.7/2014