HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED"- [
Date: 1 51 1 Permit Number: 1-I \ a- (3 1 oZ
WE D
Building Permit Application DEC 1 1. 2097
Planning and DevelopmentServices
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
—
PERM IT APPLICATION FOR: P�, 4 ,n; , yn"e. },k1
Address: a101M, uades 6iLr
Legal Description:.
Property Tax II
Site Plan Nam(
Project Name:
Setbacks Front
Back: Right Side: Left Side:
Aaaitionai worK to oe perrormea unaer tnis permit- cnecK aii tnat appiy:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator Roof %5 /ZPitch
Total Sq. Ft of Construction:
Cost of Construction:,$.. �.5 0•: ;_
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWN4ER/LESSEE:
-
k CONTRACTOR:
Name Ll Cf�:
ame:
Company ; C
Address: ME lb
F
,, 6
Addre b 8 11.E
City: � w2) '%
Zip Code:. .3qQ r] Faax::,
Phone No. IV o�D I "vim- toG `-'
/y
c G-!S'I'''T�
State_
City: P P
Zip Code: 3A L-00
Nol of , %20 -3
State:
Fax: md - &4-09W
a
E-Mail: & t' n-,e- Phone
Fill in fee simple Title Holder on ne
from the Owner listed above)
age ( if different
E-Mail P
& ; • C D
State or County License
2
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If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
5ll•PPL.EM�NTA CQNSTRIJG�'IaN �1'�fU' LAW I'N "ORYUi�1Tt0
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
_
Name:
Address: I
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Ap
licable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
I
Address:
city:
I
City:
Zip: Phone:
Zip: Phone:
I
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made,to.obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is gra II ting 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 pier)Imit, 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. aY
The following building permit applications are exemplt from undergoing a full.concurrency review:,room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and`accessory uses to adother'ndf-residential use
WARNING TO OWNER: Your failure to Recor a Notice of Commencement, may result'in your paying twice for
improvements to your property. A Notice offlCommencement 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.
ignature 0. er/ Lessee/Contractor as Agent for Owner
Signature -of Contractor/License HofdW
STATE OF FLO�jr1pA/._ - ->: l
- :;
STATE OF FLORI�A A.
COUNTY OF Lit- 0_� QJ
COUNTY OF ' J
I
The f.xing instru nt as acknowledged before a
this day of 20� by
The f rg ng instru n w s acknowledg before me
thi day of r 201J by
(Name of person acknowledging
Nam 'person acknowledging )
i
f
(Signatur Notary Public- State of Florida) I
(Signat re)of Notary Public-! to of Florida )
2100
Personally Kno O tca n
.ar Py •.
K <MAHG de ification
Persona11d
Type of'Identifi P) 4 MY coMMISSION0FF238495'
Type ofi ti tQn EXPIRES: October5,2019
Produced {a•., '. EXPIRES: October5,201s
Produce~�"' 4<? BondedThmPbtaryPublicUndmnxriters
„'r�u.uuu 1 Dru r4oury Funfic undemrftrs'
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Commission No: (Seal)'-
Commission No. -, (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION.
SEATURTLE\
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
'REVIEW
REVIEW
DATE
RECEIVED
DATE-„
COMPLETED
ev.