HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: . / ' / 1p Permit Number: Ito 0 ,' 0
REGIME
Building Permit Application JUL o 12016
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 line
PROPOSED IMPROVEMENT LOCATION =
Address: $10 S Penny Ln Four-F Pierce , FL 3`19 5 1
Legal Description: Lakewood PjeLl, - Uni'F $ - 31 k` 93 Lo+ 19 IM#40 13/62-N) (OR 3379 -26 yo)
Property Tax ID#: 1 301 -&OR -01q 8 - Do<> - 2 Lot No. 19
Site Plan Name: Block No. "1_
Project Name: JebV-,g 1Mvl rph�j
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
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lean v 4Ine Coag JAAe- r deck Arc, 41e cu-rreni code , e-e Q",r davnacged
r� dry-in GiliNn pee! Strcic. ONdetlaywen+ -aINem �ia-St7�,n� a►n.1 (;scall
cjt'v4nsicnna1 Vniw91es. 5� I.Z'�7•
TOINFRAOCO SON N
Additionalwork to be erformed under this permit-check all appy:
HVAC Gas Tank E]Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: 2 I S . Ft.of First Floor:
Cost of Construction:$ '7,2-!8 O Utilities. Sewer E]Septic Building Height:
OWNER/LESSEE CONTRACT.07R
Name Z)ebrn morptnI Name: � ��ie) cam,-oI•C�
Address: 1loS Wnny Ln. Company: &,roka 'aAV-An , LLC-
City: Far+ ?;ecce, State: r-I- Address: P.0. G5ooZ4�P
Zip Code: 311cfS I Fax: City: Vero teach , State: P;L-
Phone No. 21"7 - 12-25-7 Zip Code: 3Z9 Cc S Fax:
E-Mail: Phone No.(j7 Z) Z31 - 198 3
Fill in fee simple Title Holder on next page(if different E-Mail: Sono ka reaR nq Z a Lt.vief
from the Owner listed above) State or County License: CCC 1 3 3 000 S
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
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:
1 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:Yo failure to Record a Notice of Commencement may r u in your paying twice for
improvements to your p erty.A Notice of Commencement must be recor a and posted on the jobsite
before the first i spe . If you inten financing, consult w', h len r or an attorney before
commencingrk or cordin our N : mmencem
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F Signature of Ow /L see/Age a �^ > Signature of Contr cto License Holder
STATE OF FL NI STATE OF FL RID a m{
COUNTY OF z �"—'°' COUNTY OF • s�o f'
�.�-r1-p
The for oing Inst (nt was acknowledged befo !Ki.n ,, The forgoing ins en acknowledged b ra: _'
this �` day of 20by �N this �' day of 20DAM �T
9
m NVT
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Not ublic-State of Florida) (Signature of Vary Public-State of Florida
Personally Known R P ed Icintificati n Personally Known R Pr c d Identif ratio /
Type of Identification Produced `f 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