HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICAB E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:�Li oC I 11!7 Permit Number: R E C �" s 1 if E_ Di
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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow
Fu'LW-, Worj(S
St. Lucie County, FL
ANGELA M HUFF
Notary Publ c - Stato of Florida
It Inmis n dr IF 234730
Ayo 7, 2019
� e
PROPOSED IMPROVEMENT LOCATION: I
Address:
Legal Description: S
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Fr
0
Back: Right Side: -1, � G Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: I
CONSTRUCTION INFORMATION:
A rtional work to be performed under this permit - check all apply:
�HVAC Gas Tank ❑Gas Piping _ Shutters1:1 Windows/Doors
Electric 0 Plumbing Sprinklers ElGenerator Roof
Total Sq. Ft of Construction:
i
Cost of Construction: $ 2s6okoi
S Ft. of First Floor:
Utilities 'n Sewer O Septic Building Height:
A&
OWNER/LESSEE:
CONTRACTOR:
Name e f c_-
Name: cR v[-r--
C
Addre s: ee G`e-
Company: K (
Address: CO3 F_
rrti!/�
City: CG e— State: =
Zip Code: Fax:-,
City: F f n-
State::
Phone No G/ .-
�1
Zip Code:5 76'>
Fax: % % ,� -rr7Ikki M7
E-Mail:
Phone No. 6f61
Fill in fee simple Title Holder on next page ( if different
E-Mail:
from the Owner listed above)
State or Count License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requires.
Name:
City: .c�r�W
Zip: 0
FEE SIMPLE TITLE
Name: _ 1A1 w n ii
City: fY t 5f
Zip: -4 Phone:
State:
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name-
Address:
City:
Tip: Phone-
1 certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting b 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 herebyAgree that I will, in all respects, perform the work
in accordance witifthe 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, screepjooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice -of Commencement may result in yotlir.-oaying twice for
improvements to your prgperty. 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
commencine work or recordine vour Notice of COmmenceMeAt.) ,
Signature of Owner/ Agent/ Lessee Signature of Contractor/License Holder
STATE Y FLORIDA a�L STATE
O FLORIDA � Luc��.
COUNTYOF
The fo oing instrurrient was acknowledge b ore me The ing instrume was acknowledged before me.
thl day of 20 4by this r day of _ 20 jby
(Name of person adcnow! 'ng) . _ (Name of person acknowled ng) A a
State
Known
o�PPV P�jq'�i4
Notary Public -State of Florida
:
Commission Na * �° .= Commission(g�1g34730
".9r Poi My Comm. Expires May 27, 2019
�h�F OF F���`' annded throuoh National Notary Assn.
Revised 07/15/2014
Public -State of
Notary Public - State of Florida
Commission # FF 234!pa
My Comm. Expires May 27, 2019
Bonded througli"National Notary Assn
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