HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED f Date: Permit Number: `�O ' �4
RECEIVE®
Building Permit Application JUN '
Planning and Development Services 2 r 2�17
Building and Code Regulation Division PER TYING
2300 Virginia Avenue, Fort Pierce FL 34982 St. L ie County. FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Generator El
Address:
Legal Description:
(aY 1m -II
Property Tax ID#:I �yl.('O ' ZiIS' UU"L�I 'UL `� Lot No.
Site Plan Name: ViliBlock No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
WACR.e. IlC,U-
iAk,J�_ In S+C,(_U - 12, ()00 WGki_+- vv 1-Ir" a
C� +YUY�Qr sJ, Tj� CCnC4 " SVICa.I- I
❑HVAC U Gas Tank ❑Gas.Pl
❑Electric ❑ Plumbing ❑Sprint
Total Sq. Ft of Construction: ((�/��+�G
_/,/��} -
Cost of Construction: $ 1 l \ls'Ck)
S Ft. of First Floor: _
Utilities;In Sewer ❑ Septic
11 Windows/Doors.
❑ Roof Roof pitch
Building Height:
$'�
0111/N"EAR/LESSrEEU s '' f�
...ga�"w,s g t.' z•' v ra R° .,c7 W! " T n
C®Nl-RA`CTO,Rk a
Name
Address: AIST) I\Jw,, hjSVI Gir—
City: Pk%m C-1 -V,t State: I-
Name: "kc, O&A E(a)(I(1(1(
company: r
I Vl
L
Address: `-{ S2
Y
Zip Code: u Fax: -JI
Phone No. -r2 ' l_91Sq I
City: e71 1"
Zip Coder )
Phone No. nZ `V •) '
States: L
Fax: �, 2' 3
34-Ab
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: �l(�
YGI�U GLn'1
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
i
SUPPLEMENTAL CONSTRUCTION °LIEN LAW INFORMATION:
pp MORTGAGE COMPANY: o, , ...�
DESIGNER/ENGINEER: _ Not Applicable Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Citv:
Zip: Phone: _
Not Applicable
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
Not Applicable
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 at,erney before
commencing work or recordirVvour Notice of Commencement.
Signatur6'of Oy6neritessee/9'ontractor as Agent for Owner I Signature
STATE OF FLORIDA LA
STATE OF FLORIDA
,� 6 COUNTY OF �i COUNTY OF
The oing instr nt was acknowledge efore me
this day of aiprXnJ
20 by
(Name of on acknowledging) I � A
l�
_FsignaturLEtf Rotary P,ubic- State of F ida )
Personally Known OR Produced Identification
Type of Identificatio Produced
The Xclay
ing instr ent was acknowledge efore me
this of 20 (' by
(Name of per n acknowledging )
(Signature of Notary P lic- State of Flori )
Personally Known OR Produced Identification
Type of Identifica n Produced
Commission No. otary Publi of Florida
o Commission No.
$40
. M Antonlfam sionU�FF 1912o1
Revised 07/15/A11�
dq� NotaWWhiillc State of Florida
Antonia M Paula
n _ My commission FF 191201
Expires 021271201
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