HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
COu NTy
r L o w 1 o n
Permit N
Building Permit AeQap on
ECEIVE
DEC 2 8 2018
Planning and Development Services By Permitting Department
Building and Code Regulation Division St. Lucie Coun
ty my St. Lucie County, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial R
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: °VIE)Oa P 0 i G- i 0'!r R C'-oU r t 1
Legal Description: H6l�Ac, U, r la C 0 vnF r' j CIU10 U n ik a L o+ M (0,25
Property Tax IDlf: 0ol — 00-}y — DOd— 1 Lot No. I_
Site Plan Name: Block No.
Project Name: lo.`De"(
Setbacks Front Bac • I Right Side: Left Side: / A
;DETAILED DESCRIPTION OF WORK:
Del
tin! t9noliv lure O SGGJ/
CONSTRUCTION INFORMATION:
HUUILIU11d1 WUI R LU UC
�HVAC
CI IUIIIICU
Gas Tank
UIIUCI LI III
❑Gas
pCl IIIIL—tI1CLM1 OII
Piping
EFIFIIY.
Shutters
❑ Windows/Doors
_
❑Electric
OPlumbing
❑Sprinklers
❑Generator
❑Roof Roof pitch
Po61
1dg
Total Sq. Ft of Construction: S
Ft. of First
Floor: Kr
t
[]Septic
• ` ?QGO
Cost of Construction:
$ �uy, \
6� Utilities..
Sewer
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name t"Cf M tKbIUS
Name: L
Address:g3-\(; NW ltlo St Bo)( dJ3o1
Company: Qao s F,.I ("r LL
City: tAAAM, State:Fi,
Zip Code: -2.3 t 1 y to Fax:
Phone No. O S4 —36S — a%%(l
Address:' ,%Oka S 'F(, vier,,,\ J �AAI \j
City: PoC r 5 �-. LV C- L State: FI_
Zip Code: 3 -k1c; Fax:
Phone No. __ '-a 9 413
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: �'\Ce 6 Is I Cd
State or County License: CQC I 1 3�
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
_Not Applicable MORTGAGE COMPANY: YNot Applicable
S Name:
Slot" Place. N n,r+tn Address:
City: h State: FL_ City: State:
Zip: 7-.�y\\ Phone: I Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
Not Applicable I BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Applicable
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 thepermitholder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an 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 1 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, 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 intend to obtain financing, consult with lender or an attorney before
� ' .
_ Signature
STATE OF FLORI A
COUNTY OF k, LUU
The forgoing instrument was acknowledged before me
this V� day of Q i' c- 20 (1—by
STATE OF FL
COUNTY OF
The forgoing instrument was acknowledged before me
this ( 4 day of �%P C, 20 It_ by
Trr�l \miX I Trrrl \4 iX
(Name of pers n acknowledging) (Name of persoli acknowledging)
(Signature of Notary` Public- State of Florida)
Personally Known x ' OR Produced Identification
Type of Identification Produced
Commission No.
State of Flodda
on GG 201733
Revised 07/15/2014
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
Notary Public State
A Thomasina Bov
Fmires 03/29/2022
REVIEWS
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SUPERVISOR
PLANS
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MANGROVE
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DATE
I 1
COMPLETE
INITIALS
a