HomeMy WebLinkAboutBuilding Permit ApplicationFAPLICABLE INFO MUST BE COMPLereJ FOR APPLICATION TO BE ACCEPTED (�O ��
Permit Number:
Date: 1��v y/�^ A
W
Building Permit Application AUG 18 2017
Planning and Development Services
Building and Code Regulation Division P'e.rla'NT'i ING
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie Coynty, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential !�
PERMIT APPLICATION FOR:
Address: 114/-(2-15 /42ucelnw C-F �-f P'crce (-"L 3y951
Legal Description:
Property Tax ID #: 1,3 n 1 1 1 ' 00 0 1 — 0 00 — J
Site Plan Name: ke 5 -tea; �' .►Q% S
Project Name: _U.�.�l�._�,
Setbacks Front 3 0 " Back: 3 O " Right Side: Imo_ Left Side: 1
)ETAILED DESCRIPTION OF: WOR
Pj vild 11 —7'x-7�
ONSTRUCTIOIV INFORIVIATIQN^
Additional wor to'be performed under
HVAC _ Gas Tank
-shed 1-door
is permit - c ec K all t h at apply;
_ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: q 9 Sq. Ft. of First Floor: —
Cost of .Construction: $ V301).00 Utilities: —Sewer _Septic
Name Log � 5e. rM t eJ O►,u 5
Addressd q2nz A ZVCe,^A C$ .
City: - A, f rcr State: e
Zip Code: 3 q 2 Fax:
Phone No. 13q - `1-7i m r7H 06
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the -Owner listed above)
Lot No.
Block No.
Windows/Doors
Roof Roof pitch
Building Height: ) Z
Name: e kk'e r• J C-
Company: prC [��IJn Aru , �wl.w._��L� Gr`Yc,. --Loe-
Address:yF0 5 0 6L.E. 65 4, cr, -
cityi'9IcPGCY1obct _State: EL -
Zip Code: 3yg-i Z Fax:��
Phone No. -7 i Z 3 7a - 46 2- I. 1f
E-Mail: 10 C cikoo,Or~
State or County License: 2
If value of construction is $2500 or more, a RECORDED -Notice of Commencement is required.
SUPPLEMENTAL CONST , U - 1 ` EN LAW INF ORIVIATION
� }'`
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY:
r A of Applicable
Name: 5vweoe5i %.4 W% rrnaT�tcc�.�c� L L 6-Name:
Address: 116 3 0 SV" 5f Al
Address:
City: 61 ear i. J c'i c - State: _P-z-
City:
State:
Zip: 3 3~r 6 Phone: `7 2-1 5 3 Z - CI0d 0
Zip: Phone:
FEE SIMPLE TITLE HOLDER: LClot Applicable
BONDING COMPANY:
blot Applicable
Name: ' t
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; vour Notice of Commencement. A
ctor as Agent for Owner I Signature
er
STATE OF FLORIDA I STATE OF FLORIDA
COUNTY OF r! _�i C_ lam. COUNTY OF SXL L Li C a -
The for oing instrument was acknowledged before me
this V1 day of atA--4 f �� 20 !!by
(Name of erson acknowledging)
(Signature of Notary Public- State of Florida )
The for oing instrument was acknowledged before me
this day of 20 _L2 by
CIA6i Je s , 10h� l K k fir ,
(Name of person acknowledging )
(Signature of Notary Public- State of Florida) r /
Personally Known OR Produ ed Identification v Personally Known OR Produced Identification . V
Type of Identification Produced LP 4-- Type of Identification Produced E!�-D L
Comm! i4t TAWANDAPINKSTOQ*CASTRCI (S al) Co mi�s,on, o. (Seal)
otary Public of Florida ; otpa' Pis •, RO
Commission Al GG 099917 ►`�• Notary Public - State of Florida
# r : Commission # GG 099917
=;,9�oF �o�oP:' My Comm. Expires May 1, 2021
ll ndadfhtoughNationalNotaryAssn, BondedthreuchNationalNotaryAssr.
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IDATE
COMPLETE I h b(c) I I '1/ 1 V�
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