HomeMy WebLinkAboutBuilding permitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
'M
COUNTY
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fan 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
Legal Description:
Property Tax ID It: L\ 213E - (i?Jl (Cfl () Lot No.
Site Plan Name: Q £LbiLL cE3-\-Q4-'\ Block No.
Project Name: Qj
Setbacks Front Back: Right Side: Left Side:
DETAl1E6DES€RIPTION®WORK -99
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GONSTR eTION INFORMATION --
• dditipnal work to be
11VAC
performed under t is permit - check all.hM
Gas Tank riGas Piping
apply:
Shutters L.i Windows/Doors
Electric LIII Plumbing ESprinklers Illi Generator LIII Roof Roof pitch
Total Sq. Ft of Construction: So. Ft. of First Floor:
Cost of Construction: $ -kR4 c' 3t5 . Utilities: Li sewer [lSeptic Building Height:
7 SSEE.-__ 'CONIFrAtTOR
Name tC Sk1 Name: 4. a
Addres: S (4I$J JL t Company: C 1'-f
City: f RL $ State: Address: '?'Th\ NO LA
Zip Code:3L4 ") Fax: City: \ knr -e state:_cL
Phone No. Zip Code: 53s Fax:
E-Mail: Phone No.
Fill in fee simple Title Holder on next page if different E-Mail:
from the Owner listed above) State or County License: IWO
If value of construction is $2500 or more, a RECORDED Notice of Coi .cnencement is required.
Signature of or/License Holder
STATE OF FLORI
COUNTY OF
Commissi
- State of Florida (S4':natur OcN.V --
r Awo
onally Known
pe of ldentifica
Commis
Revised 0 /2014
Name of erson acknowled: ii:
(turoftbIi - State of Florida)
Personally Known
Type of Identificat6n Produced
(Namepf petson acknowle g
OR Produced Identification
SUPPLEMENTALCONSTRUCTibNIUIEAWINEORMATiOtF '-
DESIGNER/ENGINEER: - Not Applicable
Name:
State:
Phone:
MORTGAGE COMPANY:
Name:
Address:
Not Applicable
City: State:
Zip: Phone:
Address:
City:
Zip:
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 yo property. A Notice of Commencement must be recorded and posted on the jobsite
before the first insp; tion. If you intend to obtain financing, consult with lende,. ran attorney before
commencin: wo..qafirecordin our Notice of Commencement.
The for poing instrument was acknowledged before me
this \ S day of jtS)t-041,1, C 20 19 by
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS
Signatu r/Lessee/Contractor as Agent for Owner
STAT
CO U N
F FLORthi '
OF ç)cn 1AUJAO
The fo,çgoing instrument vas acknowledged before me
this \'6 day of JY'M1%4L42P C , 20 fl by