HomeMy WebLinkAboutBUILDING PERMIT APPLICATION�—ks
LETED FOR APPLICATION TO BE ACCEPTED
Permit Number: l� �Q,- O-Cvq3
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Aver, ve, For, Pierce FL 34.982
Phone: (772) 462-1553 Fax: (772) 462-1578
DEC 13 2018
I ST. Lucie
Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
?ROPOSEb.,IMPA EMENTLOCATIQN..;,],:-.,-
Address:
Legal Description
Property Tax ID 4: St. Lucie County
Lot No.
Site Plan Name:
Block No.
Project Name: Bpt-% LJi's C,
Setbacks Front__ Back: __ Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
'V' '7
MofVRli
Q�NR ��IOWIWFORMATION
CONS(
A tion t0uniornied
unuerthis permit- cneck all
apply:
0 HVAC
Gas
E]Ga
11, Shutters
__Shutters
L�Ilwindows/Dnnrs
0 Electric
Plumbing
OSprinklers
1:1
Roof
Total Sq Ft of Construction -
Cost of Constrjction: $ a3
S Ft of First Floor:
Sewer Se
Utilities. ptic
Building Height:
Lc-E0 SSE—E-,, ME r
q!
CONTRACTORQffne-+Zk0to
NameNcERa/
.JL-e-
Address:-5 M-POer�JL4-9TCIn�f SI b
Company.—III-C.,
City: State: EL
Address:
:L7- A-,
Zip Code: 3.149 a Fax:
city:.L�,, 12�'C-1
0. State:-F—t
Phone 1qo.-q-1k
Zip Code:3-SL4 I
Fax: S14
E-Mail:
Phone No.
Fill in fee simple Title Holder an next page ( if different
E-Mail:
from the Owner listed above)
State or County License: 0
6- 0 0,-LaJi 31,
---- --------
Y—s' wl Is JU I C. C "Ls,nWCU IMQULe Or LUM Me ncPMenT is requires.
Name:
City:
Zip: _ _ Phone:
FEE SIMPLE TITLE. HOLDER:
Name:
Address:
City:
Zip: Phone:
LIEN LA1N::IN
State:
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: _ Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
_Not Applicable
I certify tnat no wort: or installation has commenced prior to the issuance of a permit.
wh ch is inoeonflicmtawith anrepresentation
applicable lHome Owners Association rules abylaws or and covenants that build
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 I will, in all respects, perform the work
in accordance with 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, wails, 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 recording vnur Nntirp of rpm mcnre,..o..r
STATE OF FLORIDA
COUNTY
Th ef4r1dr' g instru w s acknov+ledgej,6efore me
this of Y
q--c 1<�6 A0n w.<c
Personally Known _ __ OR
Type cf Identification Pro05
Commission lJo._
Revised 07/15/2014
Ivut:tiAEL MCHALE
MY COMMISSION # 00168796
EXPIRES: December 17, 2021
STATE OF FLORIDI� I
COUNTYOF {�c=Iv1i gegf'V)
The forgoing instrument was acknowledge before me
this � day of D - . 20 JK- by
Jarin
(Name of person acknowledging )
(Signat�of Notary ubli�c-St of Florida )
Personally Known V OR Produced Identification
Type of Identification Produced
ro< ....ay" ANGELAYOUNG
Commission No. r MJGVaJ)3SI0NkFF951089
s c EXPIRES: April 12.2020
�`�OF VLCV Bono Ar,
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