HomeMy WebLinkAboutButtafuoco - 10213 Crosby Place PSL SLC 2 pagesAll APPLICAB E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1C3 l I (' Permit Number:
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:
Address: I N'2_1 3 Yt7 �i Com_ � ?b i
Legal Description: P60 cxk 1 �jefC l (� � i Pref: i n' —, 7-
Property Tax ID #: ,�� 6'� - -710 - W aC .CLOD - 9
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
Li Ke
J � � S �� (� i �'•l � � iii. � � �� c? r� .
I r� e_ Q C�YI d4 �� b 0 b 1 4-1 �4 -�l _m aD , Le c
Haaitionai worK to oe pertormea unser this permit — check all that apply:
'Mechanical T Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers _ Generator
Lot No.
Block No.
Windows/Doors
Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ k�5, I'�-5 - Utilities: _Sewer _Septic Building Height:
Namet i_ 1 1f1 it''l i�Ak-f1U3(.C9 Name: ,) L _ f1 gcAe `
Address: ICai3 6'af,10'i -Plv�-� Company; i1 �� l .4
City: P�jL 1 State: Address: 'RCX tiJ
Zip Code: 7SL0 $6 Fax: City: �� . {� , AJu'� State: �e�1
Phone No. J 1 9 - 3 — � �j (I1 f Zip Code: c'I � r7 Fax:
E -Mail: A— Phone No (50
Fill in fee simple Title Holder on next page ( if different E-Mail`j�l`S i a I �f�G�
from the Owner listed above) State or County Licens�VQ, U S-79
If value of construction is 2500 or more, a RECORDED Notice of Commencement is equired.
DESIGNER/ENGINEER:
Name:
Address:
City:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
Not Applicable MORTGAGE COMPANY:
Name:
Address:
State: City:
Zip: Phone:
if Not Applicable BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 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: 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 w6rk orwcordinR vour Notice of Commencement.
re gf,Oner/ Lessee/Agent
STATE OF FLOR
COUNTY OF �,e
The for oing instr ent was acknowledged before me
this 10day of7 k,L)e-j,- , 20AIa by
(Name of person acknowledging }
%"00111111111411
(Signature of Notary Public- State of Flok •' .•'""•••..C'�-rrir
1S810N
SABRINA L. BLACK •' ��Y2 F
Personally Known _Vol*� OR Produced IcOVEati
Type of Identification =* �►•+ •*
Produced= y OF 195337 •�
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F— — lgr�33 7 %9� ' '.'•' "dad .. 4�0,,,
Commission No. ••••••''OF �
vl%I ,114111111\\\���
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
tev.7/2014
Sig ure ontractor/License Holder
TA OF FLORI
COUNTY C �� c -i
The forgoing inst� lmI�erit was acknowledged before me
this � day of � f %�1t�c}�v 20JLpby
(Name of person acknowledging }
(Sign at u b'fLAtWf Flori �) �155)(}'
Personally Known _ OR Produced dtifigtion 'P u
Type of identification #FF 195337
Produced
Commission No. FF 19 3c3' 7
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PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW