HomeMy WebLinkAboutBuilding Permit Application P.1
Sep 1416 01:56p
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Date: Permit Number:
Building Permit Applicata n
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fart Pierce FL 34982
Phone:(772)462-1553 Fax:{772}462-1578 Commercial Residential
PERMIT APPLICATEON FOR: To Select from dropbox, click arrow at the e'nd of line
PRoPbSED IMPROVEMENT CO 7"AT164
Address: Z;
Legal Description: : DDOL 1 k'C1r1
Property'fax ID : 3 4 " 1 i 1 -� 0 O d Lot Na.
Site Plan Name-, Block No.
Project Name:
Setbacks Front Back: Right Side: Left Sid I'.
DESCL�IPT[QIV`OFWORl:
ICON TRUC`�IoN:-IN�t�E MA11'0t1 S;:.
Additional work tobe-DertGrmed under tis permit—c ec, a11 appy:
CHVAC13-- Gas Tank Gas Piping _Shutters Windows/Doors
Electric L1 Plumbing Sprinklers Generator Roof
Total Sq.Ft of Construction: Sq.Ft.of First Floorl r
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Cost of Construction:$ Utilities: ,Sewer e ptic Building Height:
O.11ilN ER/LESSEE: C(�NTRACTC}R:{;
Name ?__0t.A.-N 2.- Name: T1)S .2<+in Tullsj
Address:Z ernC� �—�c c., Company:
City: V()-,V C 5Ly L Stater Address:
Zip Code:3( q-S, Fax: City: 6r-� "fit, E:Jc(.P— i State: 5L-
Phone No. Zip Code: R-st Fax:
E-Mail: PhoneNo.1-2 I-Ii 97..3�$Z.
Fill in fee simple Title Holder on next page(if different E-Mail:Cene,5,is V�vrlb Sertd� (n from the the owner listed above) State or County Llcense:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is reguired-
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Sep 1416 01:56p p.2
SUPPLEiE1TAL C. ITRUCTiOIwIET ,LA�t1/ TNF:QR1VlATlCl�i
DE5ICNERIENGINEER: Not Applicable MOUGAGECOMPA.NY- Not Applicable
Name: Name: ;;
Address: Address:
City: State: City: State:
Zips: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name' Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone: j
f certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucle Count+makes no representation that is granting a permit will authorize thepermitholder'to build the subject structure
which is in can(Act with any applicable Home Owners Association rules,bylaws or an 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 1 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 mull concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING Tia OWNER.Your failure to Record a Notice of Commencement may resnitJn your paying twice for
improvementsto your property.A Notice of Commencement must be recorded and pasted 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_
ignature of owner/Lessee 'tr nature of Contract ir/ icense H r
STATE OF FLORIDA. STATE OF FLORIDA E
COUNTY OF -!57- L„ ;`r COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
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this day of 20 by this day of 20 by
(Mame of son ckfld� gl , ' (Nameyf'erson ac ing f
�x � ! 3 ori a
y CO
Sig t' a�( pta 1 e of or da} ary I
as
ervxa.cccr ( f enkn
Personally Known ti OR Produced Identification Personally Known 1 OR Produced Identification
Type ce,Produced -Ty–p—eldfidmithfication Produced
Commission No. (Seal) Commission No. (Sea])
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PIANS VEGETATION SEA TURTLE KIANGROVE
I COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS I