HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONN1
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEF
Date: Permit Number:
SOANNED
BV
V80
St Luble Court MAY
Perm,
. . . . . . . . . . . . . . . . . . . . . . -Building Permit Application it/179
St. tuci"
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
mi-nerclal Residential
Phone: (772) 462-1553 Fax: (772) 462-1578 C 0
PERMIT APPLICATION FOR:
. 't C9,0
Address:
Legal Description:
Property Tax ID #: 2-
Site Plan Name:
Project Name:
Setbacks Front Back: Ril
— 00,o —
Side: Left Side:
Adclitional,worto be performed under this permit cneCK an tnat apply:
I
Mechanical Gas Ta nk = Gas — Piping Shutters
Electric Plumbing Sprinklers Generator
Total Sq. Ft of Construction:
Cost of Construction: $ &00-
Sq. Ft. of First Floor:
tilities: Sewer _ Septic
Name .0_4/MS +'WAI I
Address: 0 IV it)
City: C- C C= State:! rL
Zip Code: 3 y Z_ Fax:
Phone No. ?--7 7I.
.,,.E-'Mail: q&6 elk" -a r.MAIL-(
"Pill in fee simple Title Holder on next -pagg if different
from the Owner listed above)
If value of construction is 2500 or more, a RECORDED Notice of
Lot No.
Block No.
Windows/Doors
JZ"Roof Pitch
Building Height:
Name: 41%.Ausc, ef
Company: C210A_04pel it :o 444 Je:9 "14 QQ4 060 lip
Address: 404 Jr
City: State:_Fi,
Zip'tode: 33 �' 4 Q Fax: 4'/_ 1 77 4-4Z-3 .2
Phone No ]7Lnj_!tem�
E-Mail CIAM e- 4 a7 ,
State or County License C_ C_ C_ '132 J% -7.11
I
Commencement is required.
DESIGNER/ENGINEER:' _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: J�A 61 P/A4 ti I �
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
'Name-'
Add ress:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:_
Address:
City:_
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 jobsite
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. A
A
Sign ure of Owner/ « P��Contractor as Agent for Owner
Signature of Co ractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF.�.5�
The forgoing instrument was acknowledge efore me.
! by
The fo r oing instrument was acknowledged before me
'LN
this day of 20•,
,
this day of . 201%by
(Name of person acknowledging)
(Name of person acknowledging)
(Signature of Notary Public- State of Florida)
( at re of Notary Public�S to of Florida )
Personally Known OR Produced IdentIification,-4
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced `"'
Produced.: ..
Commission -Noy �. U��7�7. Sga�4p;;'
i : o Ile ROSAIDA�NIVAR
ommissl n No. �
pY, w`,.LASHAHNAINORAMNotaryPublic-Ste
y
of Florida ?a°e�`�: Notary Public - State of Florida
ubl'
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es May1,2021 ''; -:` `
VEGETATION,
' iwy omm. Exoire�
'SEACWRTLE:l '
Dec 20, 2018
--MANG'ROVE-
.jtEVIEWS,.:,
FRONT
'`;'COUNTER
RE! EW'
REVIEW
REVIEW ;)�VI:EW.
„" R€VIEW'` r,
REVIEW � "
-
DATE
,," = =� - ;
• - _ :.I
,:-, .,
"�,. %..
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RECEIVED
-
DATE
COMPLETED"
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Rev. 7/2014