HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BtE/COMIKEETED FOR APPLICATION TO BE
Date: I-/— / /•
SCANNED
W�N ;� BY
°' St. Lucie County
ACCEPTED *&26�S
Permit Number: q 7� r;;' d
Building Permit Appl
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
n APR 2 9 2019
Permitting pepartl
St. LLlci County,
PERMIT APPLICATION FOR: /Ve y% J$ JV lbL�:- rPm j Ly
Address:
Legal Description:
Property Tax ID #: 3 OZ- Pi 146•000 Lot No._157
Site Plan Name: Block No. t -7
Project Name:
Setbacks Front Z$• Back: 15 Right Side: ? • LeftSide: '7. }
Sitcnle `0A%o,LY 0cyyie � �����52-00AA ZI/, ilP�Ii` I CnR I^
Aaai nai worK to De perrormea unaer mis permit- cnecr au maz appry:
7� �
Mechanical _Gas Tank _Gas Piping —Shutters"*.vWindows%Doors
(// Electric Plumbing Sprinklers —Generator oofL Pitch
Total Sq. Ft of Construction: 2(e(7c;� 15&-t 1 'Sq. Ft. of First Floor: SHhi�
Cost of Construction: $.� ddr�, Utilities: —Sewer ✓Septic Building Height:
�, oCj
OW,NERjLESSEE
��
'CONTRA'�CTOR
.� �.,
f
y
Name Jc,l
Name:
Address:5314'> SI?AAiTc(iL&lllN.
Company:
City: °3iN(�rt ; State: 4.
Address:
City:
State:_
Zip Code:3U 99'7 _ Fax:
Phone No. S (o I 23 4 -'7 9 1 1
Zip Code:
Phone No
Fax:
E-Mail:�.Jgij-0gr 5tA,L, 0' 6AAA•iL,C&vi
Fill in fee simple Title Holder on next page ( if different
E-Mail
State or County License
from the Owner listed above)
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
'OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit. t
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 structu es, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING WNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvem to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the t inspection. If you intend to obtain financing, consult with lender or an attorney before
commenci work or recordingour Notice of Commencement.
Nev.
:��IJPR�EN1�,nITAl3 i^ON5TE3UCTtOIV�CIEI� W1t�%1NFORMAT�ONM
�'_
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY:
Name:
_Not Applicable
Address:
Address:
City: State:
Zip: Phone
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER: _Not Applicable
Name: �
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
Signature f Owner/.Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The fo oing instrument was acknowledged before me
The forgoing instrument was acknowle ed before me
this++ day of /�1JYG� 20�y
this _ day of 20_ by
(Name of person acknowledging)
(Name of person acknowl Bing)
(' ature of Notary PI lic-Sate of Florida)
(Signature of N ary Public- State of Florida )
Personally Known OR Produced Identification ✓
Personally own OR Produced Identification
Type of Identification
ype of Identification
Produced JESSICAS.STINNETT
roduced
Notary Public, State of Florida
-
G Commission# GG 67673
Commission No.�_ (Fly