HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: to-W-01 Permit Number: 1W QIIJ '
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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of linet ,IQi�1
` Q ii tt ►VE1 l T"LOCM ION:
Address: ' 1
Legal Description: ►SIG+ O .. \n! rit O - l xrlk__r' I ` le)`Y Z� Upt 6
Property Tax ID#: �p tO`' Q\22 - QM Lot No.(0
Site Plan Name: Block No. 2 _
Project Name: ( � ' SunQlr I')t1
Setbacks Front Back: Right Side: Left Side:
PZtt1 �E
WORK:
II&Mwe. RX► l�c�j svlv\�k rW -toc1ca , Yc-tkdeck- to caA9, MS-tcalk r\.ew
Pd-S UOL , '1n-4atk new MAa l ro d
L4 111, 3Z TMrco mete,( P+S uIDL PL*1041;0 -12'1
At C01 c NCWJT 2 Ce G 5Z Mcta.l E t.
Q AnoW,
•r r Additionalwor �to DfIrrormed under this permit-cfieCK all that appy.
❑HVAC Gas Tank as Piping Shutters F]Windows/Doors
Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: 3Z 00 S . Ft.of First Floor: 25Z�
Cost of Construction:$ o Utilities:Sewer OSeptic Building Height:
X.:
s
CONTRACTOR:
Name �2��, Name:
Address: ( JV _k K 14M'�I� Company:
City: T1' �I�X Cf. Stateft/ Address: 5 l
Zip Code: ql kD _ Fax: City: Stater
Phone No. Zip Code:�ajZgb 1 Fax:
E-Mail: W MS er Vj. QD&Q.t\- C M Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail: la ee .
from the Owner listed above) State or County License: C C 1�a oci c)0
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
4. Sfi C CT14N LII~ :LAll4� IN�RI TION.
�
DESIGNER ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: C i +T('Sfl Name:
Addr ISD sfyj is Address:
City: State: City: State:
Zip: Phone: Stleb —1 g 1 - 6R R9 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 thepermit 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
commencine work or recording your Notice of Commencement.
s
_Signature of Owner/L see/ gent Sign atuli;g of—Contra&or/ '--rise Holder
STATE OF FLORIDAX,— STATE OF FLORIDA
COUNTY OF COUNTY OF� r
The orgoing instr ment was acknowledg d before me The forgoing instrument was acknowledged before me
this�day of 20�by this day of\. A1k(�_L ,20 k\,o by
(Name of person acknow 1pP)e•.,,: Name of person ackno
;moo: SONIA DESTAFNE SONIA DESTAFNEY
MY COMMISSION#FF12542 '`
* i+ �?
MY COMMISSION#FF125420
EXPIRES May 21, 201 E
�a d�.= EXPIRES May 21, 2018
(Sign tur of to Pub Signa ur o otary u t #loridlar)dallotaryService.com
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS