HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
All APPLICABLE INFO MUST BE COIV�«rED FOR APPLICATION TO BE ACCEPTED---
DateJi�—`-/_ Permit Number:
Plann
2300
Phor
PER
RECEIVED
OCT o, 5 1018
Building Permit Application 1,4rmltting o®p41rtmIent
StI:
?g and Development Services � . uele Coun cy
g and Code Regulation Division
irginia Avenue, Fort Pierce FL 349k
(772) 462-1553 Fax: (772) 462-1578
nIT APPLICATION FOR:
Commercial Residential_
Address: S(A 4 8-E2W
�f�jy+eoroa v s
Legal Description:
Lucia county
Propert yTax ID #: 13 l a S 02 (7aL9 DOLot No. J503
Site Plan Name: �'&Q-t, il,0 b SL6&eS Block No. .
PrniPrt Name- -
_M'echanical _ Gas Tank —Gas Piping
Electric Plumbing _ Sprinklers
Total Sq!. Ft of Construction:
�I
Cost of Construction:
i
Shutters
Generator
Sq. Ft. of First Floor.:
Utilities: —Sewer —Septic
-Windows/Doors'
Roof Pitch
Building Height:
® ll/NER 11188
CONT
CtC}
Name AL`-11 _5cr-46_Vt.
Name:
11 AC-
Addreis`���5 �S'ztn 8 22cg Lr%Lc (o
Company: �' ' O, Vv\ CA14;.
City: _'!�F4, Pic�tc.c: i l State: �.
Zip Code: 2g 5S1 Fax:
PhonelNo.
Address:
� 10 is l�l-`I � coi l �2
City: -�-�.
Zip Code:
Phone No
tnrcrL6c- State:
��/ s Fax:
77c2-6 7?- 15 2 (
E-Mail
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
i
E-Mail :6-5 4qIt- �iAd �c+v 1
State or County License__ _,3o0 r7
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required:
111
M` X3OWNER/
CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I 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
structure. 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 [will, in all respects, perform the work
in accordanc&w`ith�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,
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 inte to obtain financing, consul lender or an attorney before
comme 'n rk or cor in • ,, o Notice of Commenceme
S't1 � • I�EIIIIE T 1. Ca} STRU
IC}N 1.1 k.AW
tNt��
0 ;:
DESIGNER/ENGINEER:
_Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City:
State:
Zip: 'Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
Signat of Ow / e tract r -for Owner
Sign r of orit'ractor'/.Li'� se Ho der
� F FLORIDA
E OF FLORIDA
COUNTY OF 5 t1 �a
COUNTY OF Sk
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledge before me
this � day of a c� , 20A by
this _5 day of 0 1-A . 20by
(Name of person acknowledging
(Name of person acknowledging )
(Signature of Notary. Pu lic- State of Florida)
(Signature of Notary blio- State of Florida )
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
R ;'�,
Produced�-
`?»
Produced 10
1„�
Commission No.� � 5�1G GGo2 h^
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NIARIEGIVENS
Commission o,.• P � ggtON#GG(���js) 1t1
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