HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
te: (1' SCANNED
Permit Number:
BY -
• St. Lucie County RECEIVED
Building Permit Application
nning and Development Services ci 2 2�1$
Iding and Code Regulation Division ST. Lucie County, P itting
)d Virginia Avenue, Fort Pierce FL 34982 _
one: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
P,�RMIT APPLICATION FOR: Roof {�,
PROPOSED IMPROVEMENT LOCATION:
Iress: (oO�5 9PL—c-k Aui;;- f�. ?%e,-`Q IL- 3/+q5(
al Description: zuvck
pertyTaxlD#: 1'301 —�.t2-6335a�� 3
Plan Name: L-a<A,,I2Ci
ject Name:
Front Back: Right Side:
DETAILED DESCRIPTION OF WORK:
Left Side:
Lot No. 1
Block No. t 3 Z
C, NSTRUCTION INFORMATION:
Additional work to be nertormed under this permit —check all apply:
❑HVAC n Gas Tank []Gas Piping _ Shutters ❑ Windows/Doors
❑ Electric ❑ PlumbingO Sprinklers ❑ Generator Roof P-5-/5 Roof pitch
IF
Tj tal Sq. Ft of Construction: 2 SSg&avo
C?st of Construction: $ 31 5 3 3
S Ft. of First Floor: _
Utilities:Sewer ❑Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
9"
Name:
Address:
Company:
9(-05 plc-cv� Auc: .
�k. �►'ce State:-
C,Ilty:
Address: t1.56y$ 'f
Code: 34or Sl Fax:
-�` -�
City: 1) n�= Stater
lIj,p
P(ione
p
No. 1 6
Zip Code:3? Fax: *0 `i41— ozs t
dI
I
Phone No. Z?'Z.---Ill?
FMail:
in fee simple Title Holder on next page (if different
F4I111
E-Mail: C! C V '3 @ mar ` CcJ�"
frl�pm
the Owner listed above)
State or County License: 6J
due of construction is $2500 or more, a RECORDED Notice of Commencement is required.
INEER: L,' Not
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: V Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
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.
j.l 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
Istructure. 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
'n accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
j7he 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 recordirmyour N9fwe-Gf Commencement.
Signatur -of ner/ Les5seffibintra r as Agent for Owner
Signa ure of Contr or Lice (der
i
STATE OF FLORIDA
COUNTY OF ?�..e�rcr,K �c �P'L
STATE OF FLORIDA
COUNTY OF JQC,, `Q 11`
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 2(,, day of 20 G9 by
this _?�. day of 202L by
Name of person making statement
Name of person alking statement
Personally Known _X OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
i
(Signatur of No ry Pt t I BLIC
(Signature of o:ta1�y a I LIC
STATE RIDA
Commission No. a— �eFa4
Commission No. 0 STATE OF O DA
GG�B
omm# GG078567
�HCE Te�� Expires 3/2/2021
y omm#
s�NCE l Expires 3/2/2021
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
"
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
IJ
11 COMPLETED
8/2/17