HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONS
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (1
Date: f� ay'�� Permit Number:
Building Permit Application APR 2 4 2019
Planning and Development Services SCANNED
Building and Code Regulation Division BY ST. Lucie County, Per
2300 Virginia Avenue, Fort Pierce FL 34982 ;t Lucie Coupp,,�
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial �ftesidential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION: 11
_
Address: /VG % /�iti{c%Tzi -C _ _ %fG 3`//GC�3
Legal Description:
Property Tax ID #: >'ff 7 ' 3 s
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No. 7
DETAILED DESCRIPTION OF WORK: 1
TK51p✓ diC (I)o rt I�l }�o2'f �i 'T `- �e i -5 l-e'>.
a (�p Kcy-eke- III
CONSTRUCTION INFORMATION:
UHVAC "Gas Tank UGas Piping
Electric n Plumbing []Sprint
Total Sq. Ft of Construction: aAlb
Cost of Construction: $ .21 100
Shutters ❑ Windows/Doors
11 Generator 11 Roof
S Ft. of First Floor:
Utilities Ft
Building Height:
OWNER/LESSEE: I
CONTRACTOR:
Name re/'Ul/ /D M LGG
Name:
Address:
Company: L&Z}2oi�/A
City: j7os State:
Zip Code: 3 Y/0' i� Fax:
Phone No. za }
Address: 1/% Qu« P4.gr•(
City: _ Fz i �?l e"R-C-t— Stat :LL
Zip Code: 511f Fax: ✓t
Phone No. 77.Z-�77-01%7,2-337-/SFCo
/�//C
E-Mail:_ Gij�/7e iS �irrr%�ii�•C��'7
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:
State or County License: [' 6r i zs�8S3 2
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: III
Name:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: _
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State: _
Zip: Phone:
BONDING COMPANY:
Name:
Address:
Zip:
1 certify that no work or installation has commenced prior to the issuance of a permit.
Phone:
_Not Applicable
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 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 inspgaienAtyou intend to obtain financing, consult with lendeyor an attorney before
_ Signature owner/ Lessee/Agent
STATE OF FLOgRlIAgA
COUNTY OF.��
The forgoing instrunyntwas acknowledged before me
this II day of 20Mby
STATE
r
The for mg instrum t was acknowledgecj{�efore me
this day of r 20aj by
/j'l�i l:hirYl�� �('it�� I�t`tC?gwl't
(Name of person acknowledging) (Name of person acknow edging )
it _
(Signature o otary Public- State of Florida)
Personally Known OR Produced Identification X
Type of Identification Produced
csys -ceao -GQ -61 z-rs
Commission No.(26130t2$(% (Seal)
Personally Known OR Prod�u ed Identification
Type of Identification Produced i- (- hii
,P--'r-uwioaterrofFlorida °;�'`+�;5 My Commission Ex Expire II
AnnMGIo31 "%����"� Juno t2 2022p-
Revised 07/15/2014 Ann
Gio li Op 3�37i
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