HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED OR APPLICATION TO BE ACCEPTED
Date: cANNwj PermitNumber:
RECEIVED
0,
I
P Build! g Permit Applicall ionAPR 2 5 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Perml
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select Rpm dropbox, click arrow at the end of line
PROPOSED I M PROVE M ENT, LOCATI'b'
Address: b V es C_k" f 0 1p, -vb �Uce, _R
1_e-::� SA�
Legal Description: (b - u-s-7
(coap 12)11 Qn-)
Property Tax*ID #: O-D aD I 01'QC1 0 CC) Lot No
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Righ� Side: Left Side:
-RI ?lO
DETAILED:DESC PT OF
1-mr- 0- tj:�, Ig _L r
re e_ 5//
R AT I N
CONSTRUCTION'
Additional work to be nertormed under th�ispermit -check all that apply:
0HVAC []GasTank F]Gas Piping Shutters Windows/Doors
. 11 Electric F IPlumbing E]Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 71 �oo Sq. Ft. of First Floor: �A
Cost of Construction: $ UA,� -� - Utilitips: L]SewerF]Septic Building Height:
OWNER /LESSEE,'
J I
'A' to
CbNT.,,R` t R
Name vl_�X e-)nN
Name: \11X_� CAA- e -1: ia"�
Address: Loqf*j�J,) P)rvs0,,X 11, De F�_ ve
Company: 9\_6� i'e- ::J-�
city: 4�' I-efee State: EL
Address: q U�-) \?5'0'
Zip Code: Fax:
city: -e�\ 0 "_V7)enr\V\ State-
.
PhoneNo.
ip Code: 2)� Fax:
E-Mail:
P, hone No. 2) - q I
Fil I in fee simple Title Holder on next page (if different
E-Mail: Ck C_ fw)� V-� Wxhan. cou
from the owner listed above)
State or County License:Qr_.0,0�51ekE-)ax
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGN ER/ENGI NEER: Not Appi cable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: Stdte:
Zip: Phone: I
I
zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Appli �able
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zi p: Phone:
Zip: Phone:
I certify that no work or installation has commenced Orior to the issuance of a permit.
St. Lucie County makes no representation that is grant
which is in conflict with any applicable Home Owners i
structure. Please consult with your Home Owners Ass(
In consideration of the granting of this requested pern
in accordance with the approved plans, the Florida Bul
The following building permit applications are exempt
accessory structures, swimming pools, fences, walls, sl
WARNING TO OWNER: Your failure to Record
improvements to your property. A Notice of
before the first inspection. If you intend to ot
commencing work or recording vour Notice c
- Signature of Owner/ Lesseel-Agent
STATE OF FLORIDA
COUNTY OF ST Lucie
The for * instrnentwas cknowledged before me
th �'rday of i2ru . 20 LZby
-1
(Name of person acknowledging
(Signature of Notary Public- State Yf Florida )
Personally Knov# "' - -Xp_�"" OMSTIMMANEFfts"U
Type of Identifi n c6l� COMMISSION# GG 15M
-17;""P6-'S: October 18, 2021
Commission No, 'NotarigoWUnderwr
Revised 07/15/2014
ng a permit will authorize the permit holder to build the subject structure
ssoclation rules, bylaws or and covenants that may restrict or prohibit such
ciation and review your deed for any restrictions which may apply.
it, I do hereby agree that I will, in all respects, perform the work
ding Codes and St. Lucie County Amendments.
:rom undergoing a full concurrency review: room additions,
�ns, screen rooms and accessory uses ""o another non-residential use
� Notice of Commencement may result in your paying twice for
ommencement must be recorded and posted on the jobsite
I
.�Iain financing, consult with lender or an attorney before
'ICommencement.
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF St Lucie
The forgqLng instr ent was acknowledged before me
20 by
this day of ri
I
6��d kkdLaf
(Name of person acknowledging)
OML?.� MQA.L�
(Signature of Notary Public-�_tate WFIoricla
Personally Known Pmr4i irod- Identification
Type of Identificati lE RODRIGUES
MY COMINSSI
RN # GG 152040
Commission EXPI oberl6,2021
B"ded Thru NOWY PUbIIC Undemdler3
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