HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI
ALL APPLICABLE INFO lMUST BE COMPLI 1 FOR APPLICATION TO BE ACCEPTED '
Date: l 131 j`b QUgNNE1' Permit Number:
I DTI
•I I RE EIVED
Building Permit Applicati n MAR 19 2.9°8
Planning and Development Services
Building and Code Regulation Division I ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dro,pbox, click arrow at the end of line ny7)C-�-�
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax ID #:
Site Plan Name: _
Project Name:
Setbacks Front
N
7a
Back: Right Side: Left Side:
-/1-;-1: 4135-�
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
,�V�(�r a� �-f- rem �4�
_?4ZCE/_
CONSTRUCTION INFORMATION:
Additional work to be nertormed un er t is 'checkpermit-a apply:
❑HVAC0 Gas Tank, _,permit -
Piping _ Shutters OWindows/Doors
Electric � Plumbing Sprinklers 13 Generator J2Roof 31
Total Sq. Ft of Construction: c ' l S . Ft. of First Floor:
�J 06
Cost of Construction: $ /o! of2cp� . Utilities:[]Sewer Septic
I
Building Height: /5
OWNER/LESSEE:
CONTRACTOR:
Name
Address: 5Z27L
City: r4-�fr2 r-U State:a
Zip Code: _15W54 Fax:�i
Phone No. -'7-70
Name: l S E
Company: 1 Q P's "C
Address: 3 i( Q- 'er
City: nkyrf State:_J9_
Zip Code: �5ggq % Fax: -77,2 2E0774,3
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
E-Mail: v �OZ'Yl
State or County [Aense: CCC 13�0576
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTIONTfEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable 'I MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
_ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name: _
Address:
City:_
Zip:
I certify that no work or installation has commenced prior to they issuance of a permit.
Phone:
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 he 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 Commen,'cement 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.
s
_ Signature qT Owner/ ssee/Agent Signature of Contr ctor/License Holder
STATE OF FLORIDA STATE OF FLOR A
COUNTY OF k4 n ! COUNTY OF� 2f"�tllill
i
The for oing instru t was acknowledged before me The forgoing instrument w s acknowledged before me
this � day of l'IJLL 20 J by this _ day of 1t � , 20 /Fy by
0.e
(Ndme of perlWn acknowledging)
(Signature of Notary Public- State rida )
Personally Known OR Produce IIdd jntification
Type of Identification Produced _ 1—$—
Commission No. Q( (Seal)
Revised 4J§72' P( COMMISSION # GG91863
0 EXPIRES: May 17, 2021
D _ 4 )q bvc) F Irfl-2
(Name of per on acknowledging )
(Signagre of Notary Public- Stage cf F ida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
REBECCA RESTIFO
'EXpl"S: May 17, 2021
REVIEWS
FRONT
ZONING
SUPERVISOk
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
415 /i ?
COMPLETE
INITIALS