HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED U
Date: J 0 ^�O Permit Number:
RECEIVED
•
Building Permit Appli6tion�� 3 0 ,
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division 9
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Pem0l,'f%o/)
PROPOSED INPROVEMENT LOCATION:
�
Address: /070/ S 2/'
. Oee4n . �5,c" 60 y Je,'Jel Re4j 3Y90 /-7
Legal Description: V&17�ure Ouf ry//9-Id73) '
Property Tax ID#: y5'11'005- Z20 —000" / Lot No.�
Site Plan Name: Uenl"iY Block NoSec.C
Project Name: 689
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Co o/e�e p�Gr>7o '�iorl anJ rarnovo/ Oc ,mok'Y4 homf 47ne.1
7rh t r- roar,
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that appy:
_Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors
_Electric _ Plumbing _Sprinklers _Generator _ Roof Pitch
Total Sq. Ft of Construction: y0� Sq. Ft. of First Floor: !
Cost of Construction: $ J900.oe Utilities: 4Sewer _Septic Building Height:
OWNERAEnSSEE: CONTRACTOR:
Name DBsvicll J Name:
Address: //yy8� 38th ter: Company: "►•
City: LJ4rli4 State: Address: 6�/ /XLH. e4Ce�
Zip Code: 333/1 Fax: 95Y 1'7-)4/)91 City: ,-Ten.fCn 1?ee, State:FL.
Phone No. 75g, 3/7- 6yy3 zip Code: 3125 7 Fax:.7 72 2,3.2-.2,
E-Mail: '2�46ePhone No -7 - aD _3713"
Fill in fee simple Title Holder on next page ( if different E-Maila aM S�"J��i nC O/4404 %C4om
from the Owner listed above) State or County License CQe I2 Jri 1091
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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 App ' bl LANDING COMPANY: Not Applicable
Name: Name:
Address: A s:
City: City:
Zip: ne: Zip: ne:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 our Notice of Commencement.
Signature of Owner/Lessee/Contractor a gent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA L,�C�-Q
COUNTY OF 6} . Lac �� COUNTY OF Sk
The forgoing instrument was acknowledge before me Theforgoing instrument was acknowledge before me
this 3o day of c 200' by this3d day of P C 20}1_ by
6.�a r+� S+r �-1►1 Ova►a r^ S Tr"'% 1^
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary blit-State of Florida) (Signature of Nota y Public-State of Florida )
6�fiv14NY'.�V�"�[1C.:b0�t-lt,r,k.PilGb�a6.:2
Personally Known OR Produced fdR�ycfication Personally Known OR Produced Identification
Type of Identification—. �NacType of Identification
XPIRES:aemmber16,202U Produced �� U.-�1NNAMARIE
Produced V fz+ b L- s GIVENS
.1 1 r1ru Nuory Public Undetwriters 1�"YCOM'FVIC5i0N#GG 022023
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Commission No. C�bQ ea Commission No. 0 dedntNEXPIRESF�,ct 04-116,2020
Notary blit Underwdle,s
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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