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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FORAPPLiCATION TO BE ACCEPTED Date: '� • �l r( Permit'Number: _ ,� O S I Building Permit Application DEC 2 12017 Planning and Development Services Building and Code Regulation Division PERMITTING 2300 Virginia Aven.ug,-Fort-Pierce.FL 34982 Phone: (772) 462-1553 fax: (772) 462-1578 Commercial Residential St. Lucie County, FL PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of fine Uc =P.ROPOSE�P-INtPROVEMET. LOCATIGN' , ,� y, r rf Address �Z `� �-'� �- C �a2 .6 �� 5� - `�G� 2— Legal Description: �,Nk-2 I��G�e ��-f -Ee 1�'r� ©•CUB h� l 16 CCE-- 302q)-2t 2 Propertylax-6D.#; 3�4 of 6 ©� '- ©� 3 ®— ©© ' S :Lot,No., Si'te'016"ame: Biock'tio. M ��/ Protect Name: t�J` 1� /� Setbacks Front N l r- Back: "� Ri,oftSide: � Left.Sfdtle: .DETAILED DESCRIPTION QF WORK; Vt HgA4_ toog , ,100NST1341CT�.ON INFORMATIQIV trona wore to be er orme . uri er t s perm t— c ec a ❑HUAC Gas Tank DGas Ripitng , app y Shutters Windows _ L_.L jfloors �j L_1,Electric Q_. Pl.u:rnbi:ng� aprinkl:ers j l Generator 1 Roof , Roof. pitch Total Sq. Ft of Construction: 2� j x S . Ft. of First Floor: ; r�FV -Cost,of•Constructren:�$.. �_!� " tail"itiesi _�evuer �SeptNc Bui9c9ingi•9eig4�t C � r E ,`. OVVNER/LESSE- CONTRACTOR: c C. Cep 0..:,. _, ®(]�T t Name: V_'C GC 8 �j Address: gZ « tl-i �+ �d�t7 cwe_ P r Clornpany: cos-� CNLO&) 2G®O Address: SM3 S_� City: On (�c9C`c State:' �- City:.�tD CiP State: L Zip�Code: 30153 Fax: 0,..., ._ .... Phone No. �2 :�t 2 — M 2 — 23 4 f Zip Code:,S41 453 Fax, Phone No._�-:2 - 2.i-{ 0 - cl r{ Q 1, E-Mail: Fill in fee simple Title Holder on next page ( if different E-Mail: DU from the OwnerAisted above) ; State or County Ucense: F 33 ®6 Z 3 If vatue.of.toristruction is $2500 or more, a i?E!CORDED'Notice of Cbrnmeetemer fls' 'teiyuired. C04 i0ltx SUI�i��.1�1s1tIE�T,�A�Pe�NST#�#��`it7�'�I,itiiYiA�fj+�#��()R�#ATi®�4 �t r DESIGNER /-ENCiNE•Ef -. _ Appllicable MORTGAGE COMPANY.- _ Not Applicable Name: Name: Address: Address;: City: State: City: State:, ZIP: Phone: Zip: Phone: FEE SIMPLE TITLE AOL'DE _ Not Applicable T. BONDING COMP Not Applicable Name: Name: Address: Addre . city: City Zip: ' P.hflne: Zip: 'Phone: [certify that na work or instailatiorr: has commenced` prier. 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 andcovenantsthat 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: in,all: respects, perform the work in-accordance:with-the approved plans,. the Flarid ,Building Codes and St. Lucie-CountyAmend rnents. 'f�:fn44v+±�ngst��rngIr�i�•,ap{Mica=Giflns ar�eaEe��t,f��o�a,+nclergo9r�g•af�91-eQnr�rrer►�xeview;,�'ovm..adc9'iti©ns� aceessorystructures, swimming pools; fences, walls, signs, screen rooms and accesses y uses to another nun -residential: use Y,VAit eIING TO °OI�YNM Y0mr'failure to-Record.a`Ndti�ce.;ofCommencement may,msult in your payingtwice for improvements to your properfy.'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 our Notice of Commencement. caw. s 'Signature bf awnee/Lessee/Corrtractor,as<Mfor 0wryer °Sknat.ufe,ea ContractarjlTcense Holder STATE OF FLORIDA 1- hhC_"C.G STATEOF FLORIDA COUNTY OF COUNTY OF The for g instrument was acknowledged before me $C2.. The forgging instrument was acknowledged before me ;10 day20 by this -day of _LE ODy this of t��MF�c`Q� � c\e\Q) ({Mama, of pefsoKEitliNdwl`edging } (Nathe of Gerson acknowledging I (Sign re af-Natant Public -,Stage of.Fion ) (Signature o:^ry Public- State of Florida) v .Personally.Known L---'70RProduced Identification Personaliy.Known ORP.roduced.Identification T.ypeof4dentification Produced Type of Identification Produced___ . _..... . — n `�� ioNo Commission No. ��1111111j PAULETTE BLAIR-AL PUBli a XANDER O.(PaY PVB�i PAULETTE BLAIR-ALEX p P0.Y ,, �- 1 lorida a ;° = Notary Public -State of Commission # F�Sep Revlsed0711S12i334=:;P° My Comm. Expires o; Comm issi ��p��p�OP�� My Comm. Expires Sep 6 �2020 RLANS- VEGE('ATION, SE�4 TU LE MANGROVE REVIEWS FRONT. ZONING SUPERVISOR COUNTER REVIEW REVIEW REVIEW REVIEW` REVIEW REVIEW DATE COMPLETE LN IT; IAk5. )ER irida i 2020