HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONMEW
ALL AP LICABLE INFO MUST BE COMPLETED FOR APPLICATIOMTO BE ACCEPTED
Date: Permit Number: i0Oq0
RECEIVED
4 SEP 1'8 2010 8CANNED
Building Permit ApplicatiOnermilting Department g Luc
Planni g and Development Services - St. Lucie Countyle Coull
Buildi and Code Regulation Division
2300, ; ;'rginia Avenue, Fort Pierce FL 34982
Phon, (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PER I�j
IT APPLICATION FOR: WO-� 'D'amcXI
777
PROPOSED
fM'PROU.EME,NT LOCATION F,
Addr
Legal
Prope iy Tax ID #: Lot No. IAS
Site PI n Name: Block No.
Pr6jec Name-
Setba-ks Front Back: Right Side: Left Side:
tI I I
w UVNA&r.
-A
�A4Neo' �0&1
0-t — SA041zir '55S xTo e.X_
PV VI
Addltjjonaiworl(tobenertormeci
E
HVAC ID Gas Tank
under tnis permit— crreCK an
E]Gas Piping
mu apply:
LJ Shutters
F]Windows/Doors
Electric
❑
Plumbing
F—I.Sprinklers
E]Generator
El
Roof
Roof pitch
Total q. Ft of Construction:
Cost I f Construction:$ 7,1706,,66
I
Sq. Ft. of First Floor: — Utilities: oSewerE]Septic
Building Height: ;_70
Wl 'A
r.'17" 'e""'
Nam
Na%e4a_V'0
Name: Nvul L a tc_g,,,
Addr
ss: Z S
Company:
•St
ode: j_2_Z,&jcaJ Fax:
Address: W) r Le ill _UQ_
City: State:
City:
Zip,
Pho
No.
' 2A__Z�
Zip Code: -_ C14� Fax:77Z-33�5—iQSq
'?q
I
il:
E- M
Phone No. -7 7 Z��
fee simple Title Holder on next page if different
owner listed - above)
E-Mail: Se__\QC'x0\C_". a -
State or-Cou 'Pt eqfe:
O
Fill i
froml�e
If valpe of construction is $2500 or more, a RECORDED Notice of Commencement is re4uired.
_1 �`�
�l��aR�AT�OIV
51 P .EME i' A Ct�NSTRClCT1014 LIEN�LA "0111
DESI 'NER/ENGINEE :
Nam I: OI(�1C.
Addr�ss:
_ Not Applicable
.
MORTGAGE COMPANY:
Name:
Address:
of Applicable
City:
State:
City:
State:
Zips Phone 7
AO -�'77
Zip: Phone:
E� S
�P,C.`E UTILCF,IOIAER:
;Ndt App1icaib` e
"BONCIM'CO,NitIPiANY:
'Not Applicable
Nam
Name:
ss:
Addr��l
Address:
City:
City:
1 Phone:
Zip: Phone:
Zip:
Owl�that
/ONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certi nowork or installation has commenced prior to the issuance of a permit.
St. Luci County makes no representation that is granting a permit wilt authorize the permit horder to build the subject structure
which i in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structu�e Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In cons) eration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accotdance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The Poll .lowing building permit applications are exempt from undergoing a full concurrency review: room additions,
access I[y structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
W ING TO OWNER: Your failure to Record a.Notice of Commencement .may.result.in your.paying twice for
impro ements to yoU,r�property. i4`if�Idticebf Comn9encerr�et�t st be'recorded and posted on the jobsite
befog the first inspection. If you intend to obtain financing, consult with lender or an attorney before
rnm anriria wrtrie nr rprnrrlina vniir Nntirp of rnmmenrement_ i
Signature ctor/License Holder
Signalliure
of caner/ Lessee/Contractor as Agent for Owner
STATE
OF FLORIDA
STATE OF FLOR1112A
CO
TY OF S k Lv _ c.'i 4,
COUNTY OF
The
f r oing instrument was acknowledge before me
The forg ing instrument was acknowledged before me
this
day of Se ,ate , zoAS by
this day of S;a} 20_\A by
Name of person making statement
Name of person making statement
Pers
nally Known OR Produced Identification
Personally Known OR Produced Identification
Typ
o>F.Identffication
Tape o'f4denti ication
Pro
ced yc- lb t,
Produced IFL 6 A -
(Sig ature of Notary Publ - State of Florida
(Signature of Notary P lic- State o GNENS
`ENZp23
t�
Co ission No. V411 PMP� �,0p2 02p
y'
Or_*t4AMARIE G02202S
Commission No. 4,: _' ► YCOM►�tS�16,2020 yi
e�
,01
G
, - XP1RES' otaNPublic Unde nvrite�
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vs °`a � .;k �• �� \(LES Oe ryp�b\�e
y PU9
i,'• <:�(�e� ` 6ondedTh�-
RE
IEWSM�
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SUPERVISOR
PLANS
VEGETAfiON
SEA TURTLE
MANGROVE
t'T
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
REdEIVED
�g (Y
iS�2d
CO
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Rev. 12/17 A� /