HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALLAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit NumbI"
LCIVED
DEC 2 8
2018
Building Permit Applicatio
9
Planning and Development Services Permittin DePartment
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
i
OW
WWI WIN
Address: 01 o ki C1na o f 6I1G ) C4 �1 t3y
St. Etiche eounti
I
Legal Description: V., 1�4'4e' (Pe> L13-3a) 5�(, 6 Lo k a 3
J
Property Tax ID c,-o(- o 1()T_-0Q0-) Lot No. a3
Site Plan Name: 'SRf_\AC_e_'C Block No.
Project Name: qf Vice Y
Setbacks Front Back: k LV .0(31 Right Side: Left Side: q.1
E mm"'I
M Q'I
p06 cA e U
0
Ai
y
w."pp
Additional worl(tobe perTormed under this permit -check all apply:
11HVAC LiGasTank E]Gas Piping Mutters Windows/Doors
2E[ectric Plumbingtd} OSprinklers 11 Generator Roof
Pool
Total Sq. Ft of Construction: VU-1L S FtSewer of First Floor:
Cost of Construction:$ U '1 (0 6 Utilities..
IlOSeptic Building Height:
Fwg
_77t
Name'SPe1nrX,r, K0_(C'A
Name, r 14 \t,3
Address: "OLok,
Company: 19l6's 61 C'C54 -T-0 C_
City: Port, S�_ 6tate: ]E�_
Address: VV9(o S. '-F-t VJ
City: PSC State: FL
Zip Code: 31101,01 to Fax:
Phan ! e No. qqt S
Zip Code:3 Ll 00; QL
E-Mail:
Phone No. 1-7 a -
Fill in fee simple Title Holder on next page if different
E-Mail: 0 K i cL Q 00 (-s 6 r%A 5 hc. Coo
State or County License:
from'the Owner listed above)
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
A
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: A i GS
Name:
Address:
Address:
I a 1(S S(o Place N nr+ln
Cityr 6, State: FL_
City: State:
Zip: 2a�\\ Phone: -
Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I certify that no work or installation has commenced priorto 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
bylaws
which' is in conflict with any applicable Home Owners Association rules, 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 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, 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
obtain
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencin work or recordingour Notice
c
LZIAZ�_4 Li
s
_ Signature ot9 ner/ Lessee Agent
Signature of Cce7actor/Licefise Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Gk, U)6 C.
COUNTY OF !S&A_ k1C\Q,
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 61 � day of T]Cc. 20 Eby
this _2L day of 1)C-C. 20 A_ by
�trlr�! \j�9 i X
Tr rr�( \fJ i X
(Name of pers n acknowledging)
(Name of persoilil acknowledging)
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
>�
Personally Known >i OR Produced Identification
Personally Known OR Produced Identification
Type of Identification Produced
Type of Identification Produced
Commission No. e I
mmission No.
�yv Notary Public State of Florida
,s'r P1 Notary Public State of Florida
A ThOmasina Bowins
My Commission GG 207733 .1JW Expires 03/29/2022
Revised07/15/2014 �+raad4P E%Plfea03129/2022
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