HomeMy WebLinkAboutBuilding Permit Application ALI.APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: � � • J Permit Number. �J
CEIVE6
OCT 0 6 2017
BUildi.ng Permit Application PERMIr,r,rvG
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 X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of lineroo
PROPOSED IMPROVEMENT LOCATION:
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Address:
Legal Description: <��1CJ-►� 1� "M 0_1 i"i Sr2 v"t"► '"�I
�1�-toss W E`w L1(!Ss w4oz?46.1) 66) COS
Property Tax ID#: 551$313-W01' 6D_3 Lot No.
Site Plan Name: Block No.
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Project Name: L1U'�l1' n v--)- F, `
Setbacks Front . Back: ♦ Right Sider Left Side:
DETAILED DESCRIPTION OF WORK:
�l1�lIY1!`(11�1� p�o� � �C,rL-Pall e,�G10�uf�
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CONSTRUCTION INFORMATION:
itiona wor to e e orme under this permit-check all apply:
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1_]HVAC _Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
LbJ Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$-3T bOa.06 Utilities: _Sewer Septic Building Height:
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OWNER/LESSEE: CONTRACTOR:
Name A Name:— 8ca Evtc��,sI I
Address: 'r6 `p` 1 bilvb Company: Ameri n Pools&Sp s i
City: Stater Address: 1126 Old Dixie Highway i
Zip Code: � Fax: City: Vero Beach State: FL
Phone No.--n���6�)o• t030O Zip Code:
32960 Fax: 407-847-9342
E-Mail: Phone No. 772-777-8655
Fill in fee simple Title Holder on next page(if different E-Mail: craigmaccoy@america-poois.com
from the Owner listed above) State or County License: 057251 9
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPP'LEM�ENTAL CONSTRUCTION LIEN _LAW IN�FORMATIQ'N:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: WII1 State: City: Stater
Zip: Phone: Zip: Phone:
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FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY- Not Applicable
Name: Name:
Address: Address: NNI `
City: City: I
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.
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.
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Signature of Owner/Lessee/Contractor s Agent for Owner Signature, Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Indian River COUNTY OF Indian River
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The forgoing instruImJe�was acknowledged me The forgoing instrument as acknowledged before me
this day of C� 20 j /by this day of O 20 by
(Name of person nowledging) (Name person acknowledging) l
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(Signature of Notary Publi -State of Florida r (Sign a of Nota Public-State of Florida)
Personally Known OR Produced Identification cch Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
C�� o'°aw
NOTARY PUB C
Commission No FL Commission No. Craig Emmatte M"g"
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NOTARY PUBLIC
Comm#FF99Wi STATE OF FLORIDA
Comm#FF99WI
Revised 07/15/2014 Expires SMW020
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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