HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONIr
ALL APPLICABLE.INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
� Date: lilc�k a1 Permit Number:
'RECEIVED.
---� .-- Building Permit Application
SEP 21 2018
Planning and Development.Services .
Builds g and Code Regulation Division
�, ST. Lucie County Permittini�
2300 Virginia Avenue, Fort Pierce FL 34982
PhonIli : (772)-462-1553 Fax: (772) 462-1578 Commercial Residential
MI
PERMIT APPLICATION FOR:. To Select -from dropbox, click arrow -at the end of line
Baal :.
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:' �% .�✓� r✓L1S�l�� c G15
Property Tax ID #: 7 �� = D� :� '� Ci D Lot No.
Site Plan Name Block No
P,roj6c.t Name: 1 I . .
Set4�'llcks Front Back: .Right Sidi* Left.Side:
DETAILED DESCRIPTI N OF WORK:
i
II � .-
II .
CONSTRUCTION INFORMATION:
itiona wor .to e ertormed under tis. permit -check a apply:
���C HV C G Tank Gas Piping _Shutters . Q Windows%Doors
Electric L�'J Plumbing Sprinklers __Generator Roof Roof pitch
Tot, l l Sq. Ft of Construction:. S . Ft. of First Floor:
,O1
Co �t of Construction: $ W� . Utilities: _ Sewer Septic Building Height:
.OWNER/LESSEE:
CONTRACTOR:
Na'�me ,ah�t/70 ,Q t//�Q CE7,�i/S
Name: �/+r+'►CS Tit A.�1 S ZeV a 04 n- a
Company: __ /�¢ 6L Ceivc'LCTg /-70
Address:... y/D - 99Q [)Vt_
Ad''dress:22—'7.> ,,0T1 ��+0� 4,11Gy AP.
Gsly: }�L 1S�cri�% U/cu, State: rW
Zjp Code: Fax:
Pt��one No. -
City: 8iznce State:,
Zip Code: 3'�f 9-2- Fax: 772-�f0-144Y
E;IMaiI
Phone No. 72'� �7g— 775 Z -
Fill
f lil
in fee simple Title Holder on next.page ( if different
m the Owner listed above)
- E-Mail• ABJk M I 4 AAM. @ ftNG fo-0 /S . 6'aP?
State or County License: C(�C / Y.S 71BZ
of construction is 52500 or more, a RECORDED Notice of Commencement is required,
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
I,.
.DESIGNi R/ENGGII LEER:
Not Applicable
MORTGAGE COMPANY:: =-Not-Applicable.
Name: 11/,f '% WeiniL i0120.
AF-W 1/70IV/
Name: .
Address' o/d �s
4CL L•✓
Address:
City: i1 Ptic-e �o� S
State: �-/,
City: _' State:
Zip:.3x!1F e-.. Phone: .:77A
S17
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY: Not Applicable
Name: it
Name:
Addres
-Address:
-City:.
City:
:Zip: :Phone;
Zip: -'Phone:
y
i
I certify, hat no work- or. installation has commenced prior, to the issuance of a permit:,
. St. LucieilCounmakes no representation that is granting a permitwill authorize the permit holder.to'build:the subject.structure.
'which isllln conflict with: any applicable Home OwnersAssociation rules, bylaws or and covenants that may restrict or prohibit such
structurb. 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. reouested permit,,l do:hereby agree that f will, in.all'respects,_ perform.the work.
in acco'�idance.withfhe approved plans, the Florida Building Codes and St. Lucie County Amendments.
The follwing building permit applications are exempt from undergoing a.full concurrency review: room additions,
accesso� structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use .
-WARNING TO O.WNER:.Your failure to Record a Notice of Commencement may result.in your paying twice:for
improkments to.your property: A -Notice of Commencement must be'recorded and.posted on.the jo.bsite.
before the first inspection. If you intend to obtain financing, consult with lender. Oran attorney before
comniencin work or recording our. Notice of Commencement.
Si . ulre of Owner/Lessee/ ntractor'as A e r Owner
Si re of"Contract 01License Holder
I
STATE OF..FLORID�., j ' l /�
COUNTY OF: �J1. �l..Vtl/�
STATE OF FLORI
COUNTY OF .
l. . :.
. .
The f oing instrumen was a knowledgej� efore.me
o
The ing instrument was acknowledged before me .:
this 9 day of 20 1by :
this:or
day of 20 by.
111
f�
me-S T Lwnia ' 8
...
Jame' T- LeOru;� rd
.(Na of of person acknowledging-) .
Ily
) .
(Na.me of person acknowledgingeel
I
AVAIV
(Sig " ea of Notary Public- S e of Florida)
(Signat r of Notary Public- ate cW.Florida) .:
Perslnally Known. L/ OR Produced Identification
Personally Known OR Produced Identification:
Type,?"of Identification Produced
Type of Identification'Produced
COnI Ission No. :''µ` Ou WBORSODI=BIRMINGHAM .
Notary Public -State of Florida
Commission No: .
01• °ii A OR50DI•BIRMINGHAM
?!�'��' Notary Public State of Florida
Commission p GG 249
Commission rr GG 249625
y comm. pires.Aug.16. 2022
or F` : '` . My Gomm. Expires Aug-16.2022
Bonded -through National Notary Assn.
RdOsed�07/15/2014 .
Bonded through National Notary Assn.
�Id
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