HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLae•: _D FOR APPLICATION TO BE ACCEPTED
Date:' 5' Permit Number: o29L
14. .3
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Building Permit Application AUG 15 2/as?
Planning and Development Services PERM N17i: G
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential V
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSEDIMPROVEM ENT LOCATION
Address: 63V5 C-04 AMC -L 0C
Legal Description:Sabat &i-iL use IV lot Ise►
Property Tax ID #: t�cp On A Ot3 61 Lot No. �_
Site Plan Name:1. I K Block No.
Project Name: tACk l 1 r\ )
Setbacks, Front-�Back: l=_ 1`f "mil Right Side:
Left Side:
DETAILED DESCRIPTION OF WORK
Kjtw swimm,111l Pwt + GkeCK COnsin trucfla
CONSTRUCTION-INFORMATION:`
Additional work to e nerformed under . tis permit - check all apply:
OHVAC OGasTank ❑Gas Piping _ Shutters Q Windows/Doors
Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ 45 , wo . o0 Utilities: Sewer ElSeptic Building Height:
-OWNER/LESSEE ,' . " _..
CONTRACTOR:
Name n
Name: f`
Address:
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Company: cQ - AG (/jZ
City: �rt a LUCAe- State:
Address: /sVq � kowZ �A (/ � .
Zip Code: �p Fax:
City: �2 S' &we_ State: PY
Phone No. " l_i)q �q 35�15
Zip Code: .3It C193 Fax:
E-Mail:
Phone No. - 2&
Fill in fee simple Title Holder on next page ( if different
E-Mail: Vi ! 6/!?1-1a1�zXiL19 • Cam
State or County License: r PC- �9 26
from the Owner listed above)
If value of construction is $2550.0 or; m�orret,1 a RECORDED Notice of Commencement is required.
93
SUPPLEMENTAL CONSTRUCTION L EN LAWINFORMATION
.. - .... .._..._
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: _Not Applicable
Name:
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 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 your Notice of Commencement.
V13
Agent for Owner
STATE OF FLO A STATE OF FLORIDq(�fG�
COUNTY OF �i{ - C. COUNTY OF 01
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this I day of AtAn 20 (1 by this I day of WQ 20 V7 by
6(am M40,u k V i ta l l- ?1tatroj<
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public- State
Personally Known OR Pr ion
Type of Identification Prodduc�ed o e I ent'f' t
Commission No. � u%-C. �63 \ (Seal)
NICH LO E APONTE
1 MY e�aa� may
EXpI i -
Revised 07/15/2014 EXPIRES may�� 2020
•M•
(Signature of Notary P blic- State of Florida )
Personally Known A_�OR Produced Identification
Type of Identification Produced
No. 1 ' -' 1 (Seal)
....,nLE 0,P00tE
MY comraju_._
EXPIRES May �'�
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGE TION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS