HomeMy WebLinkAboutBuilding Permit Application ... ..........
.,J?PUCA5LE INFO MUST BE COMIPWW FOR APPUC1kT1OKTO BE ACCEPTED
Date: Perrnit Nurntmr:
Building Per Application MAY 0 9 2017
Planning and Demloproent 3vivim PERM(TING
Building and Code ftgukWon DWon St. Lucie County, FL
2300 Virginia Avenue,rort Pierce FL 3082 Residential
Phone-(772)4624553 .Fax.(772)462-157:9 Commercial
PERMIT APPLICATION FOR:
Address, '72767 X Rf
Legal Description-.
Property Tax lD#- Lot No._
Site Plan Name-, Block N6.
Project Name.
Setbacks Front__ Back: Right Side: Left Side:
/4jrGil r�S
4(AYq-C- 47vr dAv
"a work to be pertormed Unoertn!Sperm it-cheCKatitnatapp rym
—Mechanical —Gas Tank Gas Piping Shutters Windows/Doors
—Electric —Plumbing Sprinklers Generator Roof
Total Sq.Ft of Construction: Sq.Ft.of First Floor.
Cost of Construction:$ utilities: _Sewer _Septic Ruilding Height:
Name W,*1116,M
Name: �-U-r t t s, Sw%Fn g
Address: JH rJ Company: Cas-rvit V
--
city: P OJO, State: 2L
Address: tk 15
Zip Code. Fox., City:
V027 SzUk
.'f -Zip Code:_3.JJ2�_ Fax
Phone Na,_
E-Mail; phone No.
R11 In fee simple Title Holder an next page(If different E-Mail: -tj I
from the owner Wed akimm) State or County License. CA e 0 1 1
if value of wrftvftn is Or more,a RECORD00 Wce of Commengem9"t Is mqufr0d.
SIJI'I'[_EMkltilii�I_:C:UI'+t5l1�[;M.f,:1't�hF�CtINLA.W INf-C�Ft#1fI;A.fIUIV: • ' .
DESIGNERf ENGINEER: Not Applicable MORTGAGE COMPANY. Not Applicable
Name: blame:
Address: Address:
City: State: City: State:
Zip: Rhone: Zip: Phone:
FEE SIMPLE TITLE I QLDER. Not Applicable BONDING COMPANY: ,,,,_,Not Applicable
Name: Name;
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
i
I certify that no work or installation hascommenced prior to the issuance of a permit-
St.
ermitSt.Lucie Coun makes no representation that is grantinga permit will authorize thedpermit holder to build the subject structure
which is in co list with any applicable Nome 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 l will,in all respects,perform the work
in accordance tivith the approved plans,,the Plorida Building Codes and St.Lucie County Amendments_
The following building permit applications are exempttfrom undergoing a full concurrency review:room additions,
accessory structures,swimming pool-,,fences,walls,signs,screen rooms and accessory rises to another non-residential use
WARNING TO OWNER;Your failure to Record a Notice of Commencement MNV 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 recqording your Notice of Commencement.
t 5
Signature of Owner/Lessee/Contractor as Agent for owner Signature of Contractor/License Holder
STATE OF FLORIDA t7,1 STATE OF FLORIDA
COUNTY OF J Ic z u erI COUNTY OF rIz. 4--act-e.
The for ping instrument was acknowledged before rise The forgoing instrument was acknowledged before me
thisday of_ 20 ! Y this f day of. 4f4y 20 >7 lay
r 7
} L.Idf, MMon S' #27"1 S_ S14t'Y'!mo!r1 5_
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of F! a) (signature of Notary Public Stat of Florl
Personally Known '�Z OR Produced identification Personally Known Y"/OR Produced Identification
Type of Identification Produces! Type of Identification Produced
pp /`+ r t/ +' CHRI rW ,r. { N
Commission No,( V7 0 11941-41 c.RRrSMS nlisslon No.t3?t?f�of�`7 � t y•i^r'• �{6
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Raised 0711512014 co seen eva
REVIEWS FRONT ; ZONING ! SUPERVISOEPLANS
}'VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEWEW REVIEW REViM REVIEW
DATE -- _
COMPi.ETE
INITIALS