HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETE U" OR APPLICATION TO BE ACCEPTED
Date:a vs\Nk Permit Number:
.:� .. r SCANNED RECEIVED
F- BY
St Lucie Couniv
Building Permit Ap licait M
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: i�( dC , � � 1
PROPQSED INPROVEMENT_LQCA`I`tC}1� .
Address: f! ,b5-Rso RcLl2 S 21Ucl rt-•A%cf-ce-Fz'— 2YNSY
Legal Description: Zgke alud (::�rk- k,,,ii - q' 8/IC f I (olo+ LZ
Property Tax ID#:/30`'(0l1 ' �3tl� -G�-� Lot No. 'ZZ
Site Plan Name: Block No. If 6
Proiect Name:
Setbacks Front
Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK "
iZe (Wl'xee_ 2x�' sf �N Fay F'� ►-� . " _
f?l�cc.� t.a a f i. S•I'iC t�6c.iN c+•&C �=✓C��.'iL�
/ilelf
CQNSTRUCTION INFO.RIVIATION
Additional work to be per o med under this permit— c ec k all that app y:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator ��
_ Roof 'ID j�C* Pitch
Total Sq. Ft of Construction: eab fy Sq. Ft. of First Floor:
Cost of Construction: $1t10•Qa Utilities: —Sewer _Septic Building Height:
QINNER/LESSEE:
CONTRACTOR:
Name 1U'c.,5�, A3 V.J'r-t
Address: 67v!57 Pk5,,. 206(e2 101oal
Name:
Company:
City: r'- P"-C re- State: FG
Zip Code: `�$�/ Fax:
Phone No. V7Z 3*3 Z— O73 53
E-Mail^�Lvi ��i✓`-�
Address:
City: State:
Zip Code: Fax:
Phone No
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
7-7
SUPPLEMENTAL CQNSTRUCTION LIEN LAV1( INFORMATIQN
`
DESIGNER/ENGINEER: Not Applicable
,
_
MORTGAGE COMPANY: Not Applicable
Name:
_
Name,
Address:
Address:
City: 4 : State:
City: State:
.Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: , .Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made tobbtain a permit to do the work and installation as indicated.
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
is in Home Owners Association bylaws that
which conflict with any applicable rules, or and covenants 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
comnAjicing wprjeor recording ur Notice of Commencement.
5i ure Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLOPIDA
STATE OF FLORIDA
COUNTY OF N- Vy c'%e
COUNTY OF
The forgoing instrume t was acknowledged before me
The forgoing instrument was acknowledged before me
thisl3 day of 'V� - , 20� by
this day of . 20_ by
��3�`�v" NAO.i ��,1C Y1
(Name of person acknowledging)
(Name of person acknowledging)
(Signature of Nota Public- State of Florida)
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced V 1-3DL..`�'
Produced
. ,,..<m AMARIEGIVE%S
Commission No. �S (Siti�i N#oo0220-
Commission No. (Seal)
rU'ES�pecoemb2r16,2020te�s
SIR
4 n., a publlcUr
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OF F�O�
REVIEWS
FRONT
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTE
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 712014