HomeMy WebLinkAboutBuilding Permit Application- — - - • •-.�.r Lam: cc.r%Jr: fA1-['L1LA I JUN i U lit ACCEPTED
Date:
Permit Number:
L`-
I.
_: Building Permit Application
plcnn�ng 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 IVIX
PERMIT APPLICATION FOR: To Select from dropbox, dick arrow at the end of line
PROPOSED IMPROVEMENT LOCATION
Andress:
Legal Description: Ki V i-� 3 - 1 [Act i=
Property Tax ID 4: .3"f 1 _5 2-0- 003 2.
Site Plan Name.-
Project
ame:Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OE WORK:
leptuc 2 4U 3[k i (ten e(e�,rlCha-tec"
CONSTRUCTION INFORMATION:
A Itrana wartobeej arrne urs epy
rt Isperrnit—C ec a a ap:
11HVAC i �I Cas Tank OGas Piping _ Shutters
Electric plumbing E]Sprinklers Generator
Total Sq. Ft of Constl!uction:
S Ft. of First Floor: _
Cost of Constructionfl $ J�
—� Utilities: � Sewer L E�Septic
OvvlVER LE:.3SEEI'
Name - Who c 0 f)a
City: S+ side State: M-.
Zip Code: � Ct S ^` Fax:
Phone No.
E -Mail
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Lor No._ _
Block No. 13ec,
f� Windows/Doors
Roof
CONTRACTOR:
Name: Yft&D�, -iUIIV
Building Height:
Company: (2e 'I0Mb
Address: JqQa SC BE) r �Ave–
city:
.City: pbr-� S `¢ I d elf , State: 15-L
Zip Code: 3qqS1 Fax:
Phone No. 1'7
E -Mail: Gersess` 1t��b rvk rn r&a
State or County License: - [ V4,1
9 1
If value of construction i$ $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCT
iQN LIEN LAVV 1NFORNIATION:
lU'r-bIGNERf ENGINEER: Not Applicable _
Name: MORTGAGE COMPANY- Not Applicable
Address: Name:
City: Address=
State:
Zip: Phone_ City: State:
Zip: Phone:
PEE SIMPLE TITLE H0CD-ER: €Not Applicable Oi\i[AlfliG iQMI�AfVY:
Name: Not Applicable
Address. Name:
City: Address:
.Zip: Phone_ city.
Zip: . Phone:
I certify that no work or installation has commenced prior to the issuance of a permit..
. Lucie
makes representation ssailrlalawacvansttadstswhch is in conlictth any al€ablmeOwnneAsoctonulesbyls authorize the
oenthabuild
yrerictt subject
Poistructure h
structure. Tease 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 wont
in accordance with the approved plans, the Florida Building Codes and 5t. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessary structures, swimming pools, fences, walls, signs, screen rooms and accessary uses to another non-residential use
WARDING TO OWNER- Your failure to Record a Notice of Cdrrnmencernent may result in your paying icvirice for
improvements to your property. A !Notice of Coln mencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorn
commencing work or recordin our Notice df Commencement. ey before
%`signature of Owner(
STATE OF FLORIDA,
COUNTY OF
The forgoing instrument was acknowledged ,before me
this day of US¢- 20
{Name
Personally Known1 z ]R Produced Identification
f'V�PP i e €-a �l�i�Preduced
Commission No. {Seal)
Revised 0711.5/2014
REVIEWS FRONT ZONING SUPERVISOR
DAT1= COUNTER REVIEW REVIEW
COMPLETE i
INITIALS I
ature
STATE OF FLORIDA
COUNTY OF -5 Z'
The for oing instrument was acknowledged before me
this day of 20 k- by
(Name
Personally Known> OR Produced Identification
YPe o ,r. tion Produced
Commission No. (Seal)
i
PLANS VEGEfATI®N SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW