HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: O t'• (� Permit Number:
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SGANKLU
BY
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JUN 0 2018.
Building Permit Application
permitting Departmen
Planning and Development Services
St. Lucie County FL
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential 1
PERMIT APPLICATION FOR:. To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: / 710 . S'5D J
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Legal Description: jou
01
Property Tax ID #: 13,o" 3 y 1 — o 0 0 � f9
Lot No.
Site Plan Name:
Block No.
Project Name:
Setbacks Front Back: `Right Side: �Left:Side: 0 s`d
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional wor to be nertormed under this permit --check all I that apply:
AC LJ Gas Tank Gas Piping ShuttersWindows/Doors
WElectric�Plumbin nS rinklers G g �J p � enerator
a Roof Roof pitch
Total Sq. Ft of Construction: . �� D S . Ft. of First Floor:
Cost of Construction: $ .3-rOGG Utilities: USewer 0Septic
Building Height:
/1\Aimr-p /1 rrrrr_
I %JVVI"Ln/LCaa«; I CONTRACTOR: I
Name A!5' l C
Address:. lne7-2 a g
City: % 1 LA7LCZ State: 31/.
Zip Code: -?trl/7 Fax: N In
Phone No. - 2 % Z — 3 1— So j j
E-Mail: JU %A
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:
Company: -7A 7,#C4U/s L.Zb Af�,_0
Address: '�110 L??
City: 'e5 4E-'-7_ r_c Stater
Zip Code: YY9'92— Fax: 116?-16 254
Phone No.
E-Mail: 4AJc-
State or County License: r-19C
If value of construction is $2500 or more, a RECORDED Notice of Commencement is. required.
1
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENSS EER: Not Applicable .:
MORTGAGE COMPANY: Not Applicable .
Name: &E1�/ iiAk PC' 517424/1
Name:
Address: !D/Q e_AT?4 z 61L(ti LAI
Address:
City: ?/1Z I-L0 &A -ye- State:-W_
City: State:
Zip: 3.z 5'A 9 Phone:.
Zip: Phone:.
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
.Name:
Name:
Address:
Address.
City:
City:
-Zip: Phone:
Zip: Phone:
I certify that no work or. installation'has commenced priorto 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
-such
which is in conflict with any applicable Home Owners'Assoclation rules, bylaws or and covenants that may restrict or prohibit
structure..Please consult with your Home Owners Association and review your deed for any restrictions which may -apply.
In considerationof the grantingof 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,
accessorystructures, 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 Com.mencement.must be recorded and posted on the jobs.ite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before -
commencing work or recording our Notice of Commencement.
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Algriature of Contractor/License Holder
Signature of Owner/Lessee/Contractor as)1(gent for Owner
STATE OF FLORIDA �l
COUNTY OF L
STATE OF FLORIDA
•
COUNTY OF
The f going instrument was acknowledged before me
this day of 20by
The f rgoing igA ument was acknowledged before me
this. day of 20 )ELby
1
(Na of erso ack owl dg ng)
(Na a of pers a know Bing)
6
(signature of Notary Public- State of Florida)
(Si nature of Notary blic- State of FloriZ'ntificati
Personally-Known OR P e Iden • ication
Personally Known OR Produced I
Typeof Identification Produced
Type.of Identification Produced
Commission No.
ommission No,• "'::.... . c
HERNAbEZ
,ue°•..
FARA D HERNAND
ti°,�►e..-�Aiu
__. MY COMMISSION #FF172419
EXPIRES. October 28, 2018
'. °� . EXPIRES October 28. 2018
Revised07/15/2014'�os (407)398.0153 FloridallotaryService.com
(407)3980153 FloridallotaryService,com.:
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