HomeMy WebLinkAboutsl county wh 7.31.2017ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 4521553 Fax: (772) 462-1578 Commercial Residential
Address:
Legal Description:_
Property Tax ID #: _ 0-7 r C/ Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
c tm CiZ/I U't to VC4) t IA J Se ! Q o c
C UVV\ b2wa&
CONSTRUCTION INFORMATION: 1
iAuuiuonai worK ro De errormea unaer tnis permii:– cnecK ail tna appry:
11HVAC Gas Tank F]Gas Piping _ Shutters ❑ Windows/Doors
11 Electric Plumbing Sprinklers 0 Generator 0 Roof Roof pitch
Total Sq. Ft of Construction:rr Sq. Ft. of First Floor:
Cost of Construction: $ 1240_ „ Utilities: 0Sewer L] Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Lt kvi S
Name: t'Q�1 yQOW
Address:
City: 7 State:
Zip Code:. /r r Fax:
Phone No. 60 5627
Company:u� l
Address: GOO �?
fK). ,�
City: Q4 `� Lucy C State:
Zip Code: 5 � Fax.
Phone No. 772 77 CQAO
FL.
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail; &'006i .ice v tvo' CAD
State or County License: c—',J1gz�9 08q
VVN
IT value ar construction is �Z WU or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 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 your Notice of Commencement.
5
Signature of weer/Lessee/Contractor as Agent for Owner Signature ot,6ontractor/License Holder
STATE OF FLORIDA �
COUNTY OFIL
The forgoing instrument was acknowledged. before me
this 3cday of 20 til by
AWOL,,
(Name of person
of Notary Public- State ofl7lorida )
�
Personally Known 1
r ' .oed Identification' -Ogg
Type of Identification Prod �'= I tlii�: .n
.4'` 4, 2021
Commission No. ''�. a ,�`? (��ah.0 'sire Aaron Nary
n111-1
Revised 07/15/2014
STATE OF FLORIDA 0 1
COUNTY OF
The forgoing instrument was acknowledged before me
this )O day of J �4 Iy , 20 1'7 by
(Name of perso nowledgi
Yea
(Sig e of blic- S e of Florida j
Personally Known Of�_%d Identifi A&MType of Identification ProduF- Commission # GG101442
Fuires: tJ 4, 2421
Commission No. �a. '` 4g`, &M IilrU Aaron I♦IbFr i
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