HomeMy WebLinkAboutBuilding Permit Application r
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
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FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: 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._ 1,
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.
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Signature of Ow er/Lessee/Agent Signature of Contractor/License Holder
STATE OF STATE OF FLO DA /�
COUNTY OF FLORIDA ! `� COUNTY OF �?(/iY) j-ea�.�1
The forggifig instrument was acknowledged efore me The for:ing instru ent was acknowledged fore me
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this/ y of 4 20/g by this ... day of 20 i by ti
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(Name of�ess�n ack owledging) (Name of person acknowledgin@
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( ign ture of Notary Pub io-State of F ida) (Signatur Notary P lic Stat f Florida)
Personally Known OR Produced I•end' ication v Personally Known �/ OR Produced Identification
Type of Identificationgyp. ceBLA " 1 FE. SAY N Type of Identification Produced
n NO ARY PUBLIC
Commission No. 2� 14STATE OFDA
R�@�}y Commission No. (Seal)
i d i:Comm#FF194477 =o\P:'_.'e<,c
ANGELA YOUNG
ri ..r. E piraR 1/31/2019 * 4 , MY COMMISSION#FF 951f Rq
.. 4-1,'M= EXPIRES:April 12,2020
Revised 07/15/2014 FOF F.c- Bonded hrtu Budget Notary Serncea
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / VO)
�Date: F• 3J. )_7 Permit Number: vO�' 0
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Building Permit Application I�
Planning and Development Services AUG 3 1 2818
Building and Code Regulation Division ;I
2300 Virginia Avenue,Fort Pierce FL 34982 Permitting Department
Phone:(772)462-1553 Fax: (772)462-1578 Commercial ReSiiehtl@lp roi In'yr FL
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Legal Description: O D 02 ct+-4i.. .- SE.,c - -- I
Property Tax ID#:33e9:]'7 / / -(�Oc.3 -'COO�A Lot No. lei.
Site Plan Name: Block No.
Project Name:'i 4 cr ,,f Pa SCOe,
Setbacks Front Back: Right Side: Left Side:
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Additional work to •e erformed under this permit-check all apply: ■
741
C�HVAC —Gas Tank pas Piping' Shutters 1PJindows Doo
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0 Electric 0Plumbing Sprinklers El Generator El Roof
Total Sq. Ft of Construction: an of First Floor: --
Cost of Construction:$ 34.15./a Utilities: (Septic Building Height:
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Name j L moil', PCS i e Name: �`wvte_>`D`l�.t i,s - q.,C..1l.Si er-
Address: Q ac,a •U i ere; COQ( com an
City:Pa c±Sqt(14 6C.6 e, State: FL Address: t LE iet j '19.MN 0-1-- IL)
Zip Code:349gG Fax: City: LA).M kwrkef ,C;1,- State: F(---_
Phone
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Phone No.ac,9 - 403 5-3 q 9 .'w 112-A1-165 Zip Code:33L1 I a-- Fax: 5-tel - (5---q0511
E-Mail:4i,,no{Lyp,u,.ae i'c4-o hef Phone No. 5'W- S1 SS--- el 0S"c
Fill in fee simple Title Holder on next page(if different E-Mail: -
from the Owner listed above) State or County License: C , L" a a_a:5 31-
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.