HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABB°°LErFO
10,ST BE COMPLETED FOR APPLICATION TO BE ACCEPTEDDate: 'CJ � o-J Permit Number.
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CID
Building Permit Application OCT 2 12010
Planning and Development Services PER,.01TTi,%1G
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial _X_ Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line ��RS
P QPOSED I PROVEME T LOCATION
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Address: °mzo N AAALu -Z Far+ Time. FL A494-9
Legal Description: T iGYQ 40UVPrS unit
Property Tax ID#:_l+?5"010- 0143- CM- 5 Lot No.
Site Plan Name: --Hcoi Resicuice Block No.
Project Name: _RIsid=
Setbacks Front Back: Right Side: Left'Side:
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Q ILED DESCRIPTION tF 1NQRK � Sr ;,
_ ..,.« -
Ren-Ove and aepIace, CZ) si;ciir-9 grass dc®rs.
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"CON IN,INFORM�TON � ' N
Additionalworkto e e orme under this permit—check a appy:
HVAC Ei Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric ❑ Plumbing []Sprinklers E Generator _Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ Utilities:In Sewer OSeptic Building Height:
QNERJLESI � 4CpNTRACTQ ,
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N,alx,,k)N1J16,,2Ct _ 1��..�],1 Name;- i}'ICl OP-l'
Address: �71jUni' ` 2 ' Company.: FI A M
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C.Ity Ar YC'P State: Address: I 1
ip Code:` �4�4�" Fax i11 Q City: `5iWr_4_ _w tater
Zip Code: '?)4QR_J Fax: -37al•aek:>-640
E-Mail: ia Q Phone No. "17a-a9s(o' 0454
Fill in fee simple Title Holder on next page(if different E-Mail:�errni c�rc c tci CLU.com
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. F? I? ��
a
C 'cEMEnfi oNSTi MUM' 1Nfp�EMJIT�Oi��
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _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:
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 N tice of Commencement must be recorded and post on the jobsite
befo the first inspection. If you in nd obtain financing, consult with lender or an a o ney before
comme in work or record' r i e of Comm encem t.
l' s
Signatur of Owner/Lessee/Cont actor s Agen Owner a r of ntrac
STATE OF FLORIDA M STATE OF FLORIDA
COUNTY OF 1 i at COUNTY OF ("awn
The fo oing instrumt wa acknowledged before me The forgoing instrument was acknowledged before me
this deay of 20 jG�by this 20 day of Sept( If PJr 20 6 by
Qc�nn15 1 {all 'Dav jG tapr dj-e
(Name of persona owledging) (Name of person acknowledging)
(Signature df Notary Public-State of Florida) (Signa ure of N&bry Public-State of Florida)
Personally Known�OR Produced Identification Personally Known ✓/OR Produced Identification
Type of Identification Produced Type of Identification Produced
PETER L. EPPO
Commission No. * In ��P�` Commission No. .•+`"""�•. NMVWIDMAN
MY COMi�1f5S1ON GG024234 Notary Public-State of Florida
EXPIRES August 24,2020NN
_ Commission#FF 929255
s"i"I�j1�o;� My Comm.Expires Oct 20,2019
Revised 07/15/2014 Banded thm*National Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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INITIALS