HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 1 4 Permit Number:
Juleau
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line I
PROPOSED IMPROVEMENT LOCATION:
Address: °-I SC F 1t7� �w 17rr1 J6 6d � A-, LL�` i� (= - 31 � �S � \
Legal Description: �i J e i LLAa'�L - 1t A+ RL K 3g' LU+ )r-} NI 1`9 -IC 0 19 jai J
(OK i`1—����"7�
Property Tax ID #: 3q
Site Plan Name:
Project Name: � L- olia
, t
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Lot No. f
Block No. 5Y
•ta'Y10\m_ C)1 d C:i If L' irdk+on,f -ICA,"
7 CQ Ic-(- 0_,/� i nS�.I. ( ne--(�' CtC
onai worK to De nertormea un
HVAC Gas Tank
Electric 0 Plumbing
Total Sq. Ft of Construction: f
Cost of Construction: $ _ 'T
this permit - check all that apply:
❑Gas Piping _ Shutters
L]Sprinklers FI Generator
Sq. Ft. of First Floor: _
Utilities: Sewer Septic
Windows/Doors
Roof
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name s Cl�� 11�J . oL :
Name: _� e
Company: ,-'�hdPR()c )Uy-
UrCity:
Addres(7 2c{ �
i I + 0/e (�- .
Addre s: 31 a I StO ���1�iQ1 � ��
City:-_ y-+ S-} , L, bt e_ J State: V
Zip Code: 34 q 5 Fax:
Phone No. �l (.� �jj �j o�
City: + +
Zip Code: 3gq �?4
State:
Fax:
E -Mail:
Phone No. 7
3 1
Fill in fee simple Title Holder on next page ( if different
E -Mail: l n &o -at !
v�� ,44
from the Owner listed above)
State or County License: L -AGi'?- I U10(03
IT vaiue or construction is �z5UU 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:
Address:
City:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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 recdrding vour Notice of Commencement. n
Signatur� 4f Owner/ Lessee/
ature
STATE OF`FLORIDA��ICOUNTY
STATE OF FLORIDA,
COUNTY OF iii' Lue_i e? OF_. < cam± LI:Lc t ,.
Thefor oing instru Le
was acknowledged „before me
this / day of I -A I 20 t by
ng)
Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission NoF� % %I�IISSIONAFF914t94
pES: August 30, 2019
1.117 Woe 8011MDOSOWN" $W—
Revised 07/15/2014
The forgoing instrument was acknowledged before me
this 3 day of /,��;-r B , 20 1 S' by
edging)
of 14,6tary Public- State of Florida )
6ally Known OR Produced Identification
of Identification Produced
Commission NW7f/ /c1 M� a AYAI,'18*ABEL GL
* *iy=UW#FF914
EXPIRES: August 30,20
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