HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: (A.S 1 X 1 \ Permit Number: 11 Ora- da 55
RECEIV" =D 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 _� Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: 9 SSA S . (
Legal Description: __!_r S 1 Ct Vic` k z J. C MAC) -- W n N t bo&
.y
Property Tax lD #: � Sb 2- b O 1- t s z - GOO — 71 Lot No. y )
Site Plan Name: T 1 Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
❑HVAC
❑ Electric
���Ica`ce Sl t�1601 Slays �1toor~s
W IqAr, i" n-�pcLo 400es
0 Plumbing
❑Sprinklers
L-1 Shutters
Generator
Windows/Doors
Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 11., i Q Cl _ (og Utilities:In Sewer 0 Septic Building Height:
Name Ml1f
Address: ^'.� . d e fah �'`' C7f$
City: �G#—L K State: „
Zip Code: 3y9 S'l Fax:
Phone No. T7.1-- — 3
E-Mail: 4KCC . cnrA
Fill in fee simple Title Holder on next page i; if different
from the Owner listed above)
Roof pitch
:Name: N 1 16-
Company:'C�'1Zlr'C�� '� aW '[ nC
Addre. .1 L !t 7Bt'LkC cy'
City: 6u-e.e c+ Stater.
Zip Code: :54g9y Fax:'1-G-4.-3SM-101 b
Phone No. '7'1a - 339 - 1011
E-Mail: lani2�-1-C IIG&�r cA_AND. ii-g-j-
State or County License: SCC 1311 S 1 a�63
it value of construction is $2500 or more, a RECORDED Notice of Commencement is required. J
E
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: — Not'Applicable
Name: Name:
Address: Address:
City: State: City: State: _
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
Not Applicable
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
Not Applicable
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,ifences, 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 record,ed'.-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 vour Notice of Commencement.
ctor as Agent for Owner
STA"frFLORIDA ,
COUNTY OF S �, �.y c.ve,
The forgoing instrument was acknowledged before me
this day ofZ \l r-. k 20XI—by
z
44a
s �i�, �J'
Sign fure of C tractor/License Holder
STAT F FLORIDA '
COUNTY OF 'S,'i' • �-��
The forgoing instrument was acknowledged before me
this day of JOvs'C 20 \1__ by
S � ,nt.� `�'��� � c� � o► ,�.�.-� inn � 1 '� c �
(Name of person acknowledging) (Name of person acknowledging )
`1� %
(Signature of Notary Pub,' - State of Florida) (Signature
Personally Known OR Prod
Type of Identification Pr%d —_.
Commission No.
Revised:07/15/2014
MY COMMISSION # GG.
Personally
Type of Id(
ISSION # GG 022023 q 5n1
iQ i' rnissiomNov (Seal)''IRE c December16,2020Thru Notary Public UnderwriteJCom
1_.
REVIEWS
FRONT
ZONING'
SUPERVISOR
PLANS
VEGETATION •`
SEA TURTLE
MANGROVE
COUNTER . ;
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS