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HomeMy WebLinkAbout1610-0192 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 0,_ nC Date: /0- /,r2 Permit Number: V ED i' ' OCT 17 1016 Building Permit Application Planning and Development Services i< Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITAPPLICATION FOR: p To Select from dro box, click arrow at the end of line Address: /© 23SU 5. OC"IJ PIDUC (jom) ZZ-7 I: Legal Description: W QM ICC— Ul QUiLiF 9X TH _4 C u A)Q tJn 1 T 0_7-? L4 1 FAQ Ar _r " 75 o�e 3�5S -:/2 Property Tax ID#:_4 5-1 'i�-/0 - Q /2 `J - O OO-,3 Lot No. Site'Plan-Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: 12,'f'64G?_ x�zs�s�lr le.le. P,,Ev,Fs:Z4 f 110,11 10 I Additional worto e orme un rt is permit-c ec a appy: sT E:IHVAnk ❑Gas Piping I Shutters Q Windows/Doors i ®ElectricPlumbing []Sprinklers aGenerator Roof ! Total Sq.Ft of Construction: S Ft.of First Floor: Cost of Construction:$ 41L)0 s9-0 Utilities. Sewer liSeptic Building Height: Name /2 c Cgm p 13E[_C_ Name: Xt iU 7-H GF/2E/+1LFt QTR. Address: s0Y3 5. AI-W 266,0V drAd4_� Company: 61:5WArc.c0TG9�- City:i�ee-i State:FL- Address: b O Al" �iVT�ieP/2ISc� ��. I Zip Code:.3y9?3 Fax: _ City:�o�. 5;7- Cucry State: Phone No. 77 7- 23-9— 05'`29 Zip Code: Fax: 77,?-3V-0-7/75 E-Mail: Phone N .-7-72—3 Yo- '7 Y-7 Fill in fee simple Title Holder on next page(if different E-Mail: I.J l I 1 Qrd (9. Q(er2L.c0 C-0m from the Owner listed above) State or County License: i' If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. h DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: J Not Applicable Name: Name: Address: Address: City: State: City: State, �? Zip: Phone: Zip: Phone: FEE SIMPLE TiTLE HOLDER: Not Applicable BONDING COMPANY: &Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: 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 l: commencin wor r recordin our Notice of Commencement. S _Signature of Owner/Lessee/Agent Signature of Contractor/License Holder STATE OF FLORIDA / STATE OF FLORIDA COUNTY OF �T_ L Uci f-_ COUNTY OF ST. &C/'E- The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this /I day of 6c76;'8!2/' 20 9,zby this JJ_day of 20 /G by (Name of person ac owl dging) (Name of person ackn ledging) ature of Notary Public-State of Florida) (Signa ofNioiary Public-State of Florida) Personally Known _""� OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced Type of identification Produced I. i Commission No. °Z (Seai)TORII IL WARN Rom fission No. _a` r 's TO eLdI�ARN�R MY COMMISSION#FF 09394 MY COM ISSION#FF909394 Ao�� EXPIRES October 11,2019 EXP Igo GGt9beF 11,2019 (407)398-0!53 FbrMalloa Servka.com 1407)398-0'53 F1wk1alloar Servke.com Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE l COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE i` INITIALS •