HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: \60do-0al 3
R E C E I)i''D AUG 16 2016
law-
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fac (772)462-1578 COn'Trerciai Residential
PERMTAPPLJCATION FOR: To Select frorridMPbCV, dick anvwat the end of line a� z aC3 r
PROPGLSED IM PROVENENT LOCATION:
,Address: - a 1 1 /`� A c- ► A^ 1��'� �� I pI Q�c e , ��. 341C?
y Cl
Legal Desorption: C 0C'A I C00-t 864C,4 - SBC.-t- i oh Dn e — 61K 5 .4oi 3 1
Cdr )Ay"'- lgi9 7
PropertyTax I D 1t �"� .� — I (D '"01.q L1— 0 0 I Lot No. %31
Site Plan Nacre: Block No. .S
Project Nacre:
Setbadcs Front Bads Right Side: Left Side:
DETAI LED DESSCRI PTION OF V"IC
lRe-r )OU-c. Ane p14C-e c�Ar�� e G)ooa-.
aQI�JC110N INFORM4TON
itiona tounderthis pemit—ched<all apply.
HVAC =Gak [:]Gas Piping _Shutters aV�ArxJv�ns/Dt�ors
E
0 Electric ElPlumbing OSprinlders E Generator 0 Roof
Total Sq.Ft of Gonstruction: S Ft.of First Floor.
Castol'Gonstrt,iction:$ '2 ?V/'° Utilities: _Sev%er Septic Building Height:
GMVEF3/L6SEE: Q[X "'05IC:'fOR;
Nacre IDAy d 5 t-A e, 1 Narre:
Address: 1 �i /kA A v- i n a 1� � Con,-panV D Ve r'h e Ad D� Co of+Ae T"r- s�, �
Gty: State.rL Address: C,+ 5v,4e 3 CO 5
zip code: 3��9 `-J Fa ..c Gt �J 1 e.6'.a t4(_b State:fG
Phone No. h 3 77 — 3163R Zpcode: 33'1oL1 Fac
E IVbil: Phone No. 5—& 1" S S-) 9 7.00
Fill in fee simple Title Holder on next page(if different E Nbil: ('W i SoA,,-,)0ue-rbe4dobos4c.Coi4
from the Owner listed above) State or County Lioense. C G C/a 5-9.2 9 A
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPt EIVENTA QQi RI,IC CN UEN,LRW 11'Q; V1 CN
DESIGNER/ENGINEER: —NotApplicable
MORTGAGE COMPANY: ,Not Applicable
Name: Nacre:
,address: Address:
Qty. State: Gty: State.
Zip: Phone: Zap: Phone:
FEE SiMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: NotA,pplicable
Nacre: NarM
Address: Address:
Qty: Qty.
Zap. Phone Zip: Phone:
I certifythat novuxkor installation has comTenced p iortothe issuanoe of a perrrit.
St Lucienmkiesnor -rtationthatisgantingaperrritWllauthorizethepern-itholdertot�ldthesubiertstructure
v°ttich is in conflict vuth any appiic able i erre Ov�fiers Assoaadon rules,krAav�d or and oaverrarrts that Wray restrict c� prohibit such
structure.Please consult wth your Hones Canners Association and revienryour Gleed for any restrictions v hch rray apply.
In consideration of the granting of this requested permit,I do hereby agree that I W I I,in all respects,perfc mthe wuork
in accordance Wth the approved plans,the Florida Buildirg Codes and St.Lucie Cix-ityArrencirrents.
Thefdlowingbuldirgpem-itapplications are e<nptfrom undergoing afull ocria.nrencyreview.roomadditions,
accessory structures,sW raring pools,fences,v vis,signs,screen en roam and accessory i ses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
iWov t#s to your property.A Notice of mast be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing consult with lender or an attorney before
con-r-end rg work or reoordi og yqx Notice of
S
��`Signatu Om-ierl Lessee/Agent Signac` e of Contractor/Lieu se Holder
STATE OF FLORIDA) Vh STATE OF FLORIDA
COUNTY OF of �-h COUNTY OF P,4 i YYI
The fo�ng ir>str t vAW edged before rre The forgoing instrument v�ado-iMecged before rre
this `7 day o V U� 20 J i,y this day A u q 05 f,201�by
(Mere of-person adaiowlecUrg) (Nacre of person ackxWedgng)
(Signati e of NotaryPi 'clic-Stat9of Florida) (Signature of Ic� of Roricia)
Personally Kr � �Produced IderTafication Personally tial
Type of I ��Ar- _ Type of Identi t91�° fie
NOTARY PUBLIC fi4FPg�,PSeal)
Cormiissi STAT OR! ) Corrnission No �'SP�/ n.
}9 ' Co 7"*FF'81�
19
Revised 07/15/2014
REVIEWS FRONT ZONNG SUPERVISOR PLANS VEGETATION SEATl ETLE KA J�i�
03MTER REVIEW REVIEW RBAEW REVIEW REM EW REVIEW
RATE
COMPLETE
INITIALS