HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLr i CD FOR APPLICATION TO BE ACCEPTED /—� q ►�
Date: �aPermit Number:
Building Permit Application DEC 0 5 2017
Planning and Development Services A
PER,lill-flNG
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982 yes
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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,I?ROl?05ED111/IIPRdVMENT LQCAT(C�N, `
7003 CITRUS PARK BLVD
HU U rCSS:
Legal Description:
SEC 01/TOWN 34/RANGE39E LAKEWOOD PARK -UNIT 9 BLK101 LOTS20&21
Property Tax ID #: 1301-611-0020-000-9 Lot No. 20/21
Site Plan Name: ANDEW BOULAY Block No. 101
Project Name: ANDEW BOULAY
Setbacks Front Back: Right Side: Left Side:
dltional worK to De perrormea unaer tnis permit — ci
HVAC —Gas Tank ' _ Gas Piping
_ Electric _ Plumbing
Total Sq. Ft of Construction: 2800
Cost of Construction: $ 12000.00
Sprinklers
_ Shutters _ Windows/Doors
Generator Roof
Sq. Ft. of First Floor: 3000
Utilities: _ Sewer _Septic Building Height: 8
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CONTRACTOR 3 �k
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Name
Name:
Address:
Company:
City: F State: _
Address:
34951
FORT
Zip Code: Fax:
City: State
468-0202
34951 -468-0=
Phone No.
Zip Code: Fax:
E-Mail:
Phone No.
Fill in fee simple Title Holder on next page ( if different
E-Mail: jgcannonroo IC oU .com
from the Owner listed above)
State or County License:
If value of construction is $2500 Or more, a RECORDED Notice OT Lommencement Is requlreo.
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DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY,
_ Not Applicable
Name, COOK&MENARD ARRMT
Name:
Addr
Address:
City. ff-- State:
City:
State:
Zip: 34900 Phone: 77241507751Zip:
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 vour Notice of Commencement.
Lessee/Agent
STATE OF FLORIDA
COUNTY OF
The for oing instrpLpent was acknowledged before me
this _ day of 20 �by
Armt'3 1)A W N6 f
(Name of person acknowledging)
(Signature of Notary Public
- State of Florida )
Personally Known Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15/2014
Holder
STATE OF FLORIDA
COUNTY OF
The for oing instru ent was acknowledged before me
this day of 20 f � by
(Name o person acknowledging) _
(Signature of Notary Public- State of Florida )
Personally Known ✓ OR Produced Identification
Type of Identification Produced
KAREN �IELSEN KAREN S. MMIA N
;emmissi F 115637 Commission N °.�""�e�a.
My ComM
mission Expires ,; Commission # FF 115637
y Commission Expires
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