HomeMy WebLinkAboutBUIILDING PERMIT I
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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LSLOIAMIFRECEIVED
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Building Permit Application NOV 3 J 297
I Planning and Development Services I PER10ITTING
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
i Phone: (772)462-1553 Fax: (772)462-1578 Commercial i Residential V
PERMIT APPLICATION FOR: To Select from dropbox, chick arrow at the'end of line
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Legal Description: L�1K�l,UUoD PA�lC _/,/�tr� �A- /3L11G�-Z�1'.S ��i �� /3,y���,aS�
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Property Tax lD#: Lot No.
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Site Plan Name: Block No.—�
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Additional work to be ertormed under this permit-check all that appy:
HVAC Gas TankE]Gas Piping Shutters 'I Q Windows/Doors
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Electric El Plumbing Sprinklers E]Generator Roof Roof pitch
Total Sq. Ft of Construction: 3 6 Sq. Ft.of First Floor:
Cost of Construction:$ 1 3 g RtoQ— Utilities:oSewerFlepvc I Building Height:
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Name _DA121L76-LC- Ot✓V_Ey Name: _WWA'� S, 'kil�
Address: 7SUL IS,IiLoe-A)o _KDAD Company: /bdgtb0Vx'J?bbcT04Lr/ �Z/le•
City: r0F2E Ple2Ce State: rt- Address: IL90
Zip Code: I9 S/ Fax: /U�fP City: PORT 541 wczf:- i State: R-
Phone No. -7`1 a- 97/- EGD Zip Code: 7q5-,-- Fax: 'y'7a-3,3s--
E-Mail:
3SE-Mail:Lt)b 7/Z/)�164 -e, aa-(za- Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail: mA� ' CA��T}UAL2uy�t/JG-,
from the Owner listed above) State or County license: 0- C 1)3 aS 13
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMP,ANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: i State:
Zip: Phone: Zip: Phone:
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FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address: I
City: City:
Zip: Phone: Zip: Phone:
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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
i before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencementi
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_Signature of Owner/Lessee/Agent Signature of Cont ctor/ ' ense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S7L6107e COUNTY OF L.(,lGti
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this �day of71 20 l�by this-?i' day of CYCTMdt 20 117 by
(Name of person acknowledging) (Name bf person acknowledging 0
(Signat a of Nota Public tate of Florida) (Signature of Notary(Public-State Florida)
Personally Known OR Produced Identification,/ Personally Known OR Produced Identification
Type of Identification Produced Type of Identification'Produced
Commission No.go 0?73.7e, (Seal) Commission No.C,,, D773%'� Seal)
aopRY PVeDENISE LEMA 201���epc DENISE LEMAY
MY COMMISSION k GG 0
EXPIRES;March 23,2021
N�j Qo EXPIRES:March 23.2021 9r"OF F���o Bonded Ttvu Budget Notary Sm
Revised 07/15/2014 FpF F�� Bonded Thru Budget Notary Services
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION; SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS �
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