HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST, -BE COMPLETE FOR APPLICATIONTO BE ACCEPTED
Date: Permit Number:�5a
SGANNE
�t Lucie ��1� RECEIVED
B 'Id' it A lic ti n
lui Wing Perm ppp a MAR 2.g01$
Planning and Development Services
Building and Code.Regulation Division .. • ; ST. Lucie:County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone:-(Z72) 462=1553. Fax: (772}462-1 78 C.On11'11erCial Residential.'
eSICieCltlal X.
PERMIT APPLICATION FOR:
To Select from dropbox, click -arrow at the -end of line". a�
PROPOSED IMPROVEMENT LOCA'I'ON :-
Address:
Legal Description: 'I �C � 1� 1 �- 43 11 9(,P 3g 6: l 0�0�1�� .
"Property Tax ID #:a ' iD�'` ��' : Lot No...
Site Plan. Name:
Block No: .
Project- Name: • . �- i•ib:. . i gR .. .
Setbacks 'Front Back: . .. Right Side: � Left Side:
DETA�IErDxD,ESCR910N �OFWO`RK�a ; . r , ��y >'< r� :t.• .. 1�F h
! J ;•�i R. .s wVi'a,_'4- '�i k.-`.,}. y .# i 7 +. .'•T �s�, n.� �.-y t .-. -
CO N S^TR U CTIO,RM ATI O N
�s �•P.,.asvl.+ t
itiona -wor 'to: e e orme . under tis permit -check. a apply:
�j y
- :E]HVAC LJ Gas Tank Gas PipingShutters
�, Q Windows/Doors-
g Imo. P:.
Electric . Plumbin Sprinklers Generator El Roof - Roof pitch"
Total Sq. Ft of Construction: Sq. Ft. of First Floor: .
i.•
Cost of Construction: $. �D1 auo, (M Utilities: Sewer Septic: Building Height:.
- OWN ER/LESSEE: CONTRACTOR: -
Name �� I : ... Neme LkJ.I ��•'i a 1 ?}�,�,. S J S
Add ress:-)/� Coin pany:,' American Pools&.Spas
City: �,((ie; State: r" l . Address: 9126..OId Dixie Highway,
Zip Code: Fax: I City: Vero.Beach State: FL' -
Phone No. 1I a1—. ro d1 " g� Zip: Code:". 32960 Fax: 407-847-9342
E-Mail: Rhone No.. 772-777-8655 .
Fill"in fee sim It Title Holder on next � a e if•different . E=Mail: cr6igmacco america- ools.com
P P g i y@ P
from the Owner listed above) State or County License: 057251
it value off construction is 0506 or more; a RECORDED Notice of Commencement is required.
$ SP' •`T .K 7-
SU'PP'LENIETALC °NSTRUCTIO�f� LIENLAW IN`FORMATIONJR �y z
- •s:.a...�..c: ,W>^"...a.i+b..z:. I.,s4.-;a..�.
DESIGNS ENGINEER:,' Not Applicable. MO
:. RTGAGE COMPANY:. Not App icab
Name:.' �. • �.: .. .' ' . Name:... ...
le'
Address; Address:
City;" State: City:.. State:
Zip: ':.. Phon 1. Di Zip ne
.. 1
FEE SIMPLE TITLE HOLDER: :. No bplicable' : BONDING COMPANY:.. let'Applicable. _
. . _ f
Name: .....:. Name: . .
Address:: . :. Address:' .....
City: City. -.. '
•...
•. I .. zip. Phone:
certify that no work or installation.has commenced prior to,the.issuance'of apermit. :
St. Lucie County makes no representation that isi.granting a permit'will authorize the permit holder o' build the subject structure
which is in conflict with any applicable Homeowners 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.l 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, i aIIs, signs; screenyooms.:and accessory uses to,another non -residential -use.:
_ WARNING TO O.WNER::Your failure.to:R cord a Notice df-Commencement may result in your..paying:twice for
Improvements,to:your property: A Noti a of Commencement:must.be'recorded and posted on:the.jobsite
befor6the first inspection. if you intendito obtain: financing, consult with lender or.an attorney before
commencin :work or.recordin our:IVotice of. Commencement: .
SIgm"fure'of:Owner Lessee Contractor as Agent for Owner Signature of Contracto LicenseH.older
.STATE OF FLORIDA " :STATE.OF.FLORIDA.
COUNTY OF,IndianRiver' COONTY OF Indian Riyer
The forgoing- instrument�was acknowledged: before me The forgoing. instrument was acknowledged' before me
this 7 da .of AJ(. 1�2F� 20 f
f
y .' Y' this 2 ( day of .1-1 N@e 20 by :. .
(Name of pe on cknoWledging )_ " (Name of pe acknowledging) "
Si nature a Public- tate of Florida .rij'�rkation( g ry ) (signatu of otary Pu Ic-5t' to ofFloridaPersonally Known OR.Produce ,d n Personally Known OR Produced Identification .
Type of Identification Produced: Type of ldentificatio P oduced
..
II
Commissio Craig Emmette MacCclteaI' Commission No ral Emmette Mac al)
NOTARY P BLIC
STATE OF' FLORIDA NOTARY PUOLIC
s.
Comm# FFs94401 : OF FLORIDA
F
Revised Ofl�pires Si28/2020, Comm# F 9A44>3I
.Expires =812=
REVIEWS FRONT, ZONING SUPERVISOR' PLANS VEGETATION . SEA TURTLE .. MANGROVE.
COUNTER' REVIEW- REVIEW' REVIEW REVIEW. REVIEW 'REVIEW
DATE
ylrf�ll
COMPLETE .:
INITIALS: