HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED J
Date: ib /c Permit Number: ( � i?- U T
, 2 RECEIVED
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Building Permit Application OCT 12 2010
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 peMo��'7�ia�v
'PROPOSED IMPROVEMENT:LOCATION: ,
Address:709 &_ .w J�/eeT
Legal Description: \\_4/)d;4A> Qr✓cr F5-ak,- -ffwif D6- QLll /3 LDT5 a7,T 9. 32 2/ 44,&l3.?
Map
Property Tax ID#: /- q Lot No.
Site Plan Name: T ✓e
Q.11aly Qir- �S4�e5- Block No.13
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION,,OF WORK x
Cul offU Fex�1Qrijory Aro/e5 IN y _/ad o-F' µ4i Arouse_ aIV.1 ale �
locn�e �luM6;Ny lrNcs. Ploly.5 wit/ be- alr�'kv of IWer for p/,�6�ti� word/
Ge �/AIeS qre 1OCgkd', A150) reWtle NOu-kq4 begrz "off 6elWee,(l
77
CONSTRUCTION INFORMIAtio'N: .
Additional work to be nertormed
. under this permit-c ec a appy:
HVAC Gas Tank ❑Gas Pim Shutters Windows/Doors
Imo, Piping
i
Electric ElPlumbing OSprinklers Generator Roof Roof pitch
To#al So.-'Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ a,3�� Utilities: Sewer Deptic Building Height:
OWNER/LESSEE: _ '.CONTRACTOR:
Name_ VoaM &/� X) 5 LL Name: ediw ?.Va ' S
Address: 00 A1,F kiclAil i �4rc�eNs l�r. Company: �X6e/S/or GoNs'7<(�lC7iO.y 4 i
City: 1gigm; State: FL Address: /� S� boy/ �rFU �Jriye
Zip Code: 931Y61 Fax: City: POI` T— State:��
Phone No. Zip Code: 31 3 Fax: -77a-�/,P-x/66
E-Mail: Phone No.
Fill in fee simple Title Holder on next page (if different E-Mail: KeUj� g�eX/els�o���.uSf/uc�`ioy,�/P7�
from the Owner listed above) State or County License: 41 C 15,E
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
_ F
SUPPLEMENTAL CONSTRUCTION.LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: , 1 Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: W I Address:
City: I City:
Zip: Phone: Zip: Pho e:
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
commencing work or recording our Notice of Commencement.
s
Signature of O'/Les e/Contractor as Agent for Owner Signature of CogobctoKicense Holder
STATE OF FLORID TE OF FLORID
COUNTY OF tu, NTY OF 1�V.19��
The f oin instru ent was acknowled d before mey .. or oing instru ent was acknowledge efore meg g w this�day of '� 20/ •by �� this ay of T 20 by .
a
n
evr n aS�eKIeev n � ek_ 2 A Su
(Name of person acknowl gi g) of person acknowledging win
�, p1"TSI E$S nT
NNn T�7
(Signature Notary Public-State d Florida f (Iign ure of Nota y ublic-State of Florida �N
Personally Known ORro c d Identifi tion/ Personally Known OR Pr u�d Iden ification C
Type of Identification Produced L 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