HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: (V 1rta1 N1 Permit Number: Inoro' car.
RECEIVED JUN 12 2017
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial vloo' Residential
IPERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line s
Address:
S . C7 Ge
Legal Description: 711 4!11CLYNAIa S CAD LJA.�L* 5LD
P ro pe rty Tax I D #: +SOZ~ t,"p)-OOLP4-O00" Lot No.
Site Plan Name: Block No.
Project Name: 1-_-ACiY A i b .1
Setbacks Front Back: Right Side: Left Side:
11HVAC
❑ Electric
i-i 4PJ arc e S l k c.%Vn-k 3ka-z6 Joo les
W 40
0 Plumbing
Sprinklers
"Shutters
❑ Generator
Windows/Doors
_ Roof
Total Sq. Ft of Construction: S�Ftj of First Floor:
Cost of Construction: $ ZS� oc7b Utilities: L _1 Sewer []Septic Building Height:
Name ti PXt ,
Address:gS'SU S . C7)Ce&Vri Dr•`510
City:-2Y1S��eC..cL� State: FC.,
Zip Code: 3 `{ Cl�!i Fax:
Phone No. j -l2 - 2 -1'1 _ 3 ($ (o
E-Mail: 1r nrn!E)CA.1G <i Q Qol. ct v-A
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
to
Roof pitch
Name: - N C_tuY CA 1 t'I o,v.3 Mac_
Company: (iYj e_+ Sri i 1 t 6
Address: 3't 1 Al � Bce.(<-ey' RA
City: S+-.Ae,_kr E: State:
Zip Code: �� q G l/ Fax:
Phone No. a- 3 - I o� 1
E-Mail: - _ 1 CU `Q i- Q. V1CJA-u f'CA4 (ouJ. Y) e-7t-
State or County License: : (= 3 l 1512fa3
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
A
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3Sl1PPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION h
.,:
D ./ rn�. of p.p
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 Applicable
BONDING COMPANY: Applicable
Name:
_Not
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.i,s granting a permit will authorize the permit holder to build:the subject structure
which is in conflict with any applicable Home OwnemAssociation-rules; bylaws or and covenant's that may restrict or prohibit such
structure. Please consult with your Home.Owners Association and review your deed for any restrictions which may apply.
Inconsideration 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 toanother 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.
s
Signature o caner/Lessee/Contractor as Agent for Owner
Sig�natureontractor/License
E OF FLORIDA
SCTFLORIDA-
COUNTY OF S k 1.yc��
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this VZ1% day of 5 O vA 20 nby
this � day ofyVN-Sk_ 20 1-1 by
rba6�e�
(Name of person acknowledging)
r
(Name of person acknowledging )
(Signature of Notary Pub ' - State of Florida)
(Signature of Notary Pub is-, State of Florida )
Personally Known o:• Food ��trli S
Type of Identification `,
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Personally Known ,.•• Pro
Type of Identificatio F; c �' r1EI+/DNS
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'�:� ' 'gyp•` Bonded Thru Notary Public Underwriters
Commission No.
Decert� 020
'' EXPIRES. Lqun*yaiters
Commission No.' �,,,,,,° ondedThruN�fi�lh
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Revised 07/15/2014 -
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