HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE IN O MU T BE,COMPL D FOR APPLICATION TO BE ACCEPTED
Date: � �.` j � Permit Number:
APR 2 1
Building Permit ApplicationPUL..s. Woo s
Planning and Development Services St. Lucie County, FL
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:
Address: —�3p4- P1,
Legal Description: _Lyle
CJNST 06< S Al
Property Tax ID #: 3 40 L'- CID ?_ - d (0s 000 - f Lot No. 22 i- ?3
i
Site Plan "Name: _ Block No.
Project Name: Zkwi a C77 C.E
Setbacks Front (90 , Back: /%O",' Right Side: 5_1 ✓ Left Side: 1 0 d
(2,
Aaaitionai worK to ne pertormea under tnis permit - cnecK all tnat apply:
Mechanical _ Gas Tank _ Gas Piping —Shutters Windows/Doors
'y_ Electric IV Plumbing _ Sprinklers _ Generator Roof S /� Pitch
Total Sq. Ft of Construction: ft Sq. Ft. of. First Floor: � '
Cost of Construction: $ 70:913, Qa0 - oa Utilities: _Sewer Septic Building Height: Za ` led
Na'me:-1 I SK;: `4. 1)IdN%. L- Lr--w is
Qddba'ss:'82Z5=, ""'A" -BOR Wit V-
Stater
-:Zip Code-' `` _' Fax:
Phone No. a0l - _.? - 4 '7-7,7
E-Mail: PCl.�(1c�i ���1C�m�S-�
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: QYA)e4E5 A 5'<AAA21A)e.�.L
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Company: e4:5CD C0,4j'-5—/R4A6�QtJ
Address:24Z4,- S'E FAk41/1 ,90/JT F4
City: _a7Ui0�'T State: l-,cr
Zi Code: Fax: ` 77-- Z$7
P one No 772— Z(S - D94-1
E-Mail C_c_ 4 S CO c_ (? X04 . (:!DM
State or County License (f8C_ (P-5 e 5 q-
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If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. O� J
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencingwork or recordingour Notice of Commencement.
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SUP LL'_ .E TAL CONS�TU��TION' LIEN LAW.IN'FOR'11%iAT1Q
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DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:__ �s1T(.��.ttil�'/-�'tl' CNC.
Name:
Address:_ fg$� .�'u� �i�7'�'1oe� �7— �?F ll�
Address:
City: /�S� State: �[=
City:
State:
Zip: 3��1 S � Phone 7.'?�-`78a - ���8
Zip: Phone:
FEE SIMPLE TITLE HOLDER: �/ Not Applicable
BONDING COMPANY:
Not Applicable
Name: S',,(,�,C .�S C�1�Vdt0�1�.
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
Signature of O�vner/"C ssee/Contractor as Agent r Owner
Signature of Contractor/License Holder
1
STATE OF FLORIDA c
STATE OF FLORIDA
COUNTY OF
COUNTY OF�1�
The forgoing instru ent was a knowledged before me
The forgoing instrument was acknowledged before me
this � day of 20��by
this � day of G���� , 20 11 by
�/7'�i'•.. C.,� a /� �� iF/ 717
�h���^�-Q s Tl • S C,Y l QZS w l'i1 q
Name of person ack owledging)
(Name of person acknowledgin
(Signature of N ary Public- State of Florida)
tgna ure Notary u lic- S to of Florida)
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identifica '
Type of Identification
Iq(S337S�
Produced �
Produced t�l�_.SSSa
A GELH M HUFF
Notary f'uyl;�eaf)
Commission No. '_"" �`,�' '•- tLOlFlorida
Commission No. C"lC`1�� C' .••''���`��ea� ASHLEYFRECHETTE
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;: tary Public -State ofFlori
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