HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO -MUST BE COIMUETED FOR APPLICATION TO BE ACCEPTED
Pate: 67�� �j._.. '' � Permit Number:
SCANNED
By
- - - St Lucie County
Building Permit Application
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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 Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of fine
Address: 52 o
Legal Description: • I OL, >1m —ZNA39= " 1 9aA14 %
Property Tax ID #: 1311- S Q , C)C3 a 5.- 00 O
Site Plan Name: RKc.S F. Ebyo d 3
Project Name: L Xe4 E, itdi r4
Setbacks Front /O" Back: O 1
_. Right Side: %C Left Side: lot
fu�a �LL a14 f&4fA-JJ1- -TN k r
Gewwol
(' Co"W-Cr Fd 2 F;4a, ,
_ HVAC
_ Electric
Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ n 0 ,
1
City: �.
Zip Code:3 A 9 S I Fax:
Phone No. - 5}9 - 49 (e�
E-Mail: ALL.
—Gas Piping
_ Sprinklers
State:
_ Shutters
—Generator
Sq. Ft. of First Floor:
Lot No.q,2_
Block No.
W 11184 -L TV C
cKQ,Y.- S sue..
Utilities: —Sewer _Septic
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: 1
Company:
_ windows/Doors
_ Roof Roof pitch
Building Height:
City: ThLI"4- C[[`{ Statek-L
Zip Code: 30 99� Fax:
Phone No. "L- �2 Sb-+- 1100 a T' / 01 S
E-Mail:Jklit Alka Flag%DA CAM
State or County License: 0 5,4 5.11i
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. , /
DESIONCR/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: Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFEWIT: 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: toom 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
commencing work or recording vour'Notice of Commencement.
' a �-.0 Wr -
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �r%?'//��'� COUNTY OF r.�
The for Ding instrument was acknowledgedefore me
this day of 20� by
(Name of per on acknowledging)
re of Notary Public- State of Florida )
The forgoing instru ent was acknowledged before me
this'46*y of • 20/S by
(Name of pers n acknowledging)
of Notary Public- State of Florida )
onally Known Cl� OR Produced Identifica 'o
ersonally-Known
OR Produced Ident1ficaLi
Type of Identification r
CONNER
of IdentificationC/TProduced
-
Commission No. 4141el
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DATE -
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