HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
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ALL.APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _ O
Date: '57 '9-� 1 7 I Permit Number-
"NED
BY
st Lude M"
Building Permit Applicatio tv M 2 2018
Planning and Development Services a rtm e n t
Building and Code Regulation Division LPermitting De p2300 Virginia Avenue, Fort Pierce FL 34982 LU C I e o u it ty r i' L
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercialtt
PERMIT APPLICATION FOR: P
To Select from ro box, click arrow at the end of line
Address:
Legal Description:
;� (air a
Property Tax ID #:
Site Plan Name:
Project Name: 6
Setbacks Front
q
3-A 1 q -- 53 ) of
Back:'ti' Right Sid Left
�ut��0.�`c�`�D✓� Oj� �' vn�t'C (dO I
C-VY6 ecly Pfiwten {�
Lot No. t3
Block No. 3 a
Additional worK to be
[IHVAC
pertormect
under tnis permit - cnecK au rnat apply:
Gas Tank Gas Piping IL_JI Shutters
a Windows/Doors
electric Plumbing
Sprinklers
F1 Generator
F Roof
P001 -
ayo s-�-Ft
Total Sq. Ft of Construction: Dxc.\c_ I-G35
Sq f+
Sq
Ft. of First Floor:
Cost of Construction: $ ,3%P I%u �n
.O 0 Utilities:
Sewer
E]Septic
Building Height:
- - ----,•`� r "`,- �""''' _, ?' a' x'1"x�. ,�.c z+„�..i-. sY t�••�y`,
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s' i^,> .��, `.. '3` r`'^�-f Mlr.�^,�„f5, ., ,'J+�,,:+� A'i =�'.
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_�r`�., -'iir . idx:.
Name bf _\t-t'O L_o F
Name: 1 C cf\I \M t
Company: 9CIO iS b4 to -r_YIC-
Address:931A SE Noi a f\)A ,A\�-c
City: 9O c Y �t WC\ a State: F_I-
Address: ��b`bl9 tea, �e c��rG � �4 �u�U,\om
Zip Code: '3L44A 0 Fax:
City; -9n c t 1;{. U6 Stater
Phone No. ';qa - "3-9 Q d
Zip Code: 3yg5 a Fax:--_-a=33`$-1
E-Mail: -----
Phone No.'T:V01.-
E-Mall: 'k LR o S ; L'Urn
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License: 3
I
if value of construction is $2500 or more, a RECORDED Notice of Comri etrcement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
i
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name: -_ter eKN0y' r i
uS
Name:
Address: J I 1 a 1.15
GLo Mau, N
Address:
City:
4, State: FL_
City:
State:
Zip: 22,E\\ Phone:
- - I
I
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Not Applicable I
BONDING COMPANY-
Not Applicable
Name:
Name:
Address:
I
Address:
City:
I
City:
Zip: Phone:
Zip: Phone:
I
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 &rmit 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 dd 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
commencine work or rec6r�in>r vour Notice of commencement. l "1
Si nature o Less
- z
STATE OF R�k, l
COUNTY OF
The forgoing instrument was acknowledged before me
thiA� day of to 20 kA by
(Name of pers n acknowledging)
(Signature of Notary Public- State of Florida) 7
1
Personally Known > OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15/20
signature of Contra , or/ cense Hoicer
STATE OF ORI
COUNTY OF 6
The forgoing instrument was acknowledged before me
this i0-t day of f-A_A!sl 20 1 1q, by
I e-_rr1l W 1 X
(Name of perso(i acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known X OR Produced Identification
Type of Identification Produced
St
Commission No df°"tt, Notary Public a
_ Notary Psllate of Florida � te����a
A Thomasina Bowins ns
My Ca mn on GG 201733
i My Commission GG 201733 e . �.ee n�exrin�o
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