HomeMy WebLinkAboutBUILDING PERMIT APPPLICATIONALL APPLICABLE INFO MUST BE COMPI, 4) FOR APPLICATION TO BE ACCEPTED n ,,, ` — q�50
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Date: i— N �'I Permit Number:
CANNED ReCCIVED
BY JAN 2 2 1019
Building Permit ApplicatiOW Licie county.
Planning and Development Services Permitting department
Building and Code Regulation Division St- Lucie county
1300 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
Address: H L-,,7!, D A v<,w-T /a- W Hy - P t <SCCF_ T-1-3LA9L�"
Legal Description: 3' i-1 c3 5 E k i u o[^ r-4 W I uA L-'ES S N k ao 5 r LEI 6 (= of I 21 f
C1+ruzolccF_ 91f\) 1E;hTf3�DFQ So�rrruRap sC�33 Toy Nsh P3�1S ftAiY�E�lol;
PropertyTaxlD#: Lot No.
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Block No.
Try S�/ait_t_ AN � patl (oF1v6F �toc-�-S=J� (�-�+r��Nvr�.. 2ooF'o�E=sue
o..J C�- rro G t L_1r=_
auiuonaiworKcooe ermrmea unaercrasperrna—a
❑HVAC Gas Tank ❑Gas Piping
❑Electric El Plumbing []Sprinklers
Total Sq. Ft of Construction: c�S
Cost of Construction: $ _CS;f700 • coo
Shutters ❑ Windows/Doors
Generator g Roof
S Ft. of First Floor: _
UtilitiesSewer ❑Septic
Name W'EL-F—N i- -J S-r-orJ
Address: Lkc;3 W f3. �t
City: T-- State: L_
Zip Code: 3-k9 L4 Fax: r.1 \ Pi
Phone No.--? 7 Z. -
E-Mail: rJ\A
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Building Height: 1 b'
Name: SolFry E- Mv2
Company: 0 \ 5, �r1C
Address: "14t S• G4 - S*" Sr —
City:: 9o,^A,-4o . %aE�c-t-) State: FL
Zip Code: 33065 Fax: 95ti • 1 Ga - oq9 S
Phone No. Soo
E-Mail:
State or County License: c-C-4- Olt'a.7 S �2
of construction is $2500 or more, a RECORDED Notice of Commencement is
:IGNER/ENGINEER:
IDES
_ Not Applicable
1 MORTGAGE COMPANY: Not Applicable
Name: eta Mt c ¢.�st la�scl Iry L
Name:
Address: 33 Do r, ,F—= X of y T4Fx�-2 7k a+-t
Address:
City: Po r^ 9 r3 - 1k State: FT
City: State: .
Zip:33Phone: 9 `l.-%-SS(..
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: v Not Applicable
Name: u-c
Name:
Address: 6 So c* e~ Ay = F 6 of
Address:
City: r/F_wtiozVC N.y
City.
Zip: bot9 Phone:
Zip: Phone:
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
is in
which conflict with anyapplicable 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 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
before the first inspection. If you intend to obtain financing, consult with lend n attorney before
c.ornmencing work or recording r Notice of Commencement.
sign- atare`ofOwnrrJ` n ee
Signa ue' r `_ r Geb efiolder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF (Srto w a rz
COUNTY OF +'a N
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this n day of S AN , a n 20 liy
this _L-I_ day of -JA,.Kvti2y ' . 20_b by
�"-�_b 44 r-4 r _ M V rZ2li-�e
So I-" Cr _ M,J r�R�
(Name of person acknowledging)
(Name of person acknowledging )
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Personally Known A OR Produced Identification
Personally Known 9C OR Produced Identification
Type of Identification Produced
Type of Identification Produced
Commission No. FF l9S H`i9 (Seal)
Commission No.'F1t \9Slk�P1 (Seal)
ip .....0 ALAN MILLER
$Pony:u-c ALAN MILLER
ION A FF 19549
EXPIRES: May5,2019 EXPIRES: May5,2019
Revised07/15/2014 4TpOFh7oPa Boded ThruBudget Notary Senises 'ew O01 a Bonded rhmBudge!Notary Services
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