HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
LPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
ALL
Number: O 0' M l
Dat hermit
BY RECEIVED
�e Lucie
Counb
. - • .. .; Building Permit Application AUG 10 7018
Plan ing and Development Services Permitting DepartmentSt. Lucle County
Buil fng and Code Regulation Division
230 Virginia Avenue, Fort Pierce FL 34982
Pho l e: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
-1
PER
IT APPLICATION FOR: Roof
PRC3CJIg
.P EMlr �QC�A7f �, ..
AddrE
15 Q� ��� \hfl�'
description: CC) 0 oft
Legal
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Prop
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rty Tax ID #: 0`�11� �� �' `J — l �J�J� �i Lot No.�2�9
Site PI
n Name: Block No. (_
Proje
Name:
Se -b
cks Front Back: Right Side: Left Side:
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TRUC-,T--1, N C3R A 1 N;
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onal work to be ertormed under this permit — check all apply:
Tank ❑Gas Piping Shutters a Windows/Doors
r] i,
L_._JHVAC
L__I Gas _
E
Eiectric 0 Plumbing []Sprinklers 11 Generator L qRoof Roof pitch
Total
q. Ft of Construction: �y� �1 S . Ft. of First Floor: y YH
Cost
I
`f Construction: $ b���i Utilities:C2 Sewer Septic Building Height:
..
07
1
Nam
Name:
s: C to
Company: LCCA1 S
Addr
11 S ate: F
/
Address: ��
City:
Zip C'I
de: Fax:
City:P State:,
Phonll
No. 'D — 60 —qc
Zip Code: Fax:
1: a �-
E-M a
Phone No. _ —'
lifee simple Title Holder on next page ( if different
E-Mail:E �y)l Col �k1 ZcW
Fill in
'_
from
�he Owner listed above)
State or County License:
If valu
IL�L
of construction is $2500 or more, a RECORDED Notice of Commencement is required.
-
a
is, UIP" 1
DESI .
Nam( :
Addr
Zip
GINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:
Phone:
State:
Address:
City: State:
Zip: Phone:
FEE IMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable
Nam Name:
Addr ss: Address:
City: 1 City:
Zip: II Phone: Zip: Phone:
I certi y that no work or installation has commenced prior to the issuance of a permit.
St. Lu e County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which s in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
stru cti re. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In con ideration 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 fo lowing building permit applications are exempt from undergoing a full concurrency review: room additions,
access f ry structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WAR 4 ING 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 our Notice of Commencement.
s
Sig at i re of Owner/Lessee/Contractor as Agent for Owner Sign'atiJfreof Contractor/License Holder
STATE OF FLORI STATE OF FLORIDA
COUNTY OF . LkX�t COUNTY OF Sk . L_,,3i_,e
The tagoday
ing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this of 20 -&by this -30 day of 20 t? by
(Nam of person acknowledging) (Name of person acknowledging)
1 911 ]J ) qln,6 11 /1 1 POLL
(Sigrid of Notaryublic- State of Florida) (Signature of ary Public- State of Florida )
Personally Known OR Produced Identification Personally Known ()(,— OR Produced Identification
Type 6 Identification Produced Type of Identification Produced
,y L L
Com ssion No. 1.., ��' � (Seal) Commission No. (Seal)
SALLY PORTES
"1 '11' SALLY PORTES
-• °'� Commission M GG 47625 �a •..
Revised 07/15/2014 `' �4�':
II My Commission Expires _a+%� = Commission # GG 47625
, r, gngn
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November
15, 2020
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INITI�I
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