HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAM APPLICABLE INFO MUST BE CO � � .ETED FOR APPLICATION TO BE
Date:. L.214 -1 $ Permit Number:
SL
ucle COD*
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
RECEIV
JAN 2 4 2018
ST. Lucie County
Residential
I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of jine �I)
Address:
Legal Description: _
sr.L L.c I e FL 3YgS�
I
Property Tax ID ##: 4.2 l - SO 1 000 '- 000 - !i Lot No._3-� �
Site Plan Name: kEO -na RR. i 1 Block No.
Project Name: Lela % 1Z2� LLO
Setbacks Front J U Back: 1 O Right Side: 1 (2 Left Side: 10 l
se-r aoo).i6_ AQd�� Gaa•
R� CQkT a, CommteT ' r-b rL Fj j N L
HVAC
_ Electric
Gas Tank
_ Plumbing
rim — cnecK all inat apply:
Piping _ Shutters
Sprinklers I —Generator
AN-0 OkAC kaPk,
U t LL A- Gr.. l \ S)'D
Total Sq. Ft of Construction: n Sq. Ft. of First Floor:
Cost of Construction: $ 1 1 OC7 O Utilities: _ Sewer _ Septic
Nam
City:
State: r q,
Zip Code: 3 4462. Fax:
Phone No. �-}-r2'- 22.y -TOSZ
E-Mail: 1 0. 7Q0 A,I10 (GiI.A. L . e,iM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Windows/Doors
_ Roof Roof pitch
Building Height:
Name: 'fl Mb�r�J-1106-NTY
Company: iln!
Address:
1 �13(a SMP N w M A 9w 1(
City: Pml_. C. I_W State:F—L
Zip Code: %3 Fax:
Phone No. IP - 1• ] IQ 1D Ev- 10) S
E-Mail: TTA &l*.C, C_ o F -o lei bA . CAXAk
State or County License: OSS"
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: — Not Applicable
Name:
MORTGAGE COMPANY° ^ Not Applicable
Name:
Address:
Address:
City; State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: — Not Applicable,
Name:
BONDING COMPANY: NotApplicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain 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
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 jobsit-
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
STATE OF FLORID _ STATE OF FLORIDA
��
COUNTY OF COUNTY OF
The forgoing instruppent was acknowledged efore me
thi - 1'Slay of
Ccni7 t'ii^Sr�d'7
(Name of p rson acknowledging )
of Notary Pub c- State of Florida )
/ ersonally-Known v \ OR Produced Identification
Type of identification Produced
Commission No. fj—;6 076
REVIEWS
DATE'
Q c ded
RECEIVED
DATE
COMPLETED
The forgoing instru •rent was acknowledged efore me
this lay of - 20_Kby
Dar? /I sa—n
(Name of pets n acknowledging)
re of Notary Public- State of Florida
lrersonally Known OR Produced Identification
Type of Identification Produced
Commission No. � 07 d _
PLANS
REVIEW .
JANE �et 4a o� Flotlda