HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -1� `g Permit Number:
„ SCANNED
BY RECEIVED
Building Permit Application JAN 31 2018
Planning and Development Services ST. Lucle Goynty, Pgrmitting
Building and Code Regulation Division --- --
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential Y
PERMIT APPLICATION FOR: Roof
Address: q o Ct C,' LA).ex;IIcA U i+. PocA SA. (A)c i -e
Legal Description: i�sey.f_ 7A GLnk-,-Vk oar - 13
Property Tax ID #: _3321 - '301 - 001-b - Mia - R Lot No. 13
Site Plan Name:
Project Name:
Setbacks Front
Back:
ccc o �( unl, .
L HVAC
❑ Electric
0 Plumbing
Block No.
Right Side:
Left Side:
IB
-4'�a. $NIP
Oil
�� C2 bo4e cA ?l4 wood. dealc_. -+, czae
roa � 5�qs e y% +'z C,J,Ae .
Sprinklers
Windows/Doors
Roof r 2
Total Sq. Ft of Construction: 3w Sq. Ft.
of First Floor: Y (e (3
Cost of Construction: $ ! 513() Utilities: E) Sewer Septic Building Height: _�_
0i TRATiR°
k.;.a.$.i"zx%
Name � �,-��;..o
�,�; 1�
,�
Name: �
Y'ChC4rs1 V . Cz)1 \_,P,44
Address: (69 1K U72T
rd W tau
Company: ( (',� 1( J&5 f's
Address: (0 1C)( 13uCi�� �C r1 ri
City: \�bY 3, . . w i ;t e- State: a
Zip Code: 3�19 g (,o Fax: _
Phone No. -422- 9UA- 539S
E-Mail:
City: _� -1 , 17� ef�� State: PL
Zip Code: 349TS?- Fax: 1-42- 2('aq u �
Phone No. -4q `Z - 332- - FY 7i�
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
—1
E-Mail: y ki-ekt4-ii
State or County License:
It value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
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. �3
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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 followingbuilding permit applications are exempt from undergoing a full concurrent review: room additions )' g P PP P g g Y
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use I}.
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for �v;
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.
1 � � s
Signature of Owner/Lessee/Contractor as gent for Owner SikKature on rat or/License Holder
STATE OF FLORIDASTATE OF FLORIDA
COUNTY OF COUNTY OF cuCA P
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 X$by this day of fie, _,n" 20 iFby
(Name of person acknowledging) (Name of person acknowledging )
(Sijnatu.Ke of Notary P lic- State of Florida } (Signat of Notary P lic- State of Florida )
Personally Known �_ OR Produced Identification Personally Known 3e OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. """ 5ALLY PORTS ion No. L "
r SALLY PO
�,a` .��,,, RTES
_* *_ Commission M GG 47625 •s
F.- c Co m'
V 4 My Commission Expires
ha,,,,,,,o� November 15 , 20 20 y,,,°, V,, `;
..Revised 07/15/2014 November 15, 2020
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