HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONF�rltu
YABLE INFO MUSE BE COMP:"�p FOR APPLICATION TO BEACCEPtED
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SCANNED Permit Number:
BY
St. Lucie Counly
�' I
Building Permit Application ndDeuelopmentSe�vfrrs [—RECEV—ED—
PlanningAY 14 7019
d Code Regidntion ojmwan-
/aAveme, Fortpieme FL34SA62la 6aun[ ermltting
72)462-1553 Film(772)462-157s COmmerdal
Residential
PPLICATION FOR; To uelect from dro
D IMPROVEMENT LQCA770N: Pb�x" click arrow at the end offine
. — ••Yf.�a Jena. •v Left Side:
56o CALLon! PR eANP- 14„lk e tt g
-- F'd A FPIA.L •
-- WAC ✓ Gas Tank Vas Piping —Shutters
_ Electric _ Plumbing %rin4l®rS
_Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor. _
Cost Of Construction:$ Q :3:_j0 'p _ Wes: _Sewer _Septic
City: FT: f d IE fk% F State:
Phone No. +-f%Z - 4/0% -
Fill in fee Simple Title Holder on RM p (if different
from ties Owner listed above)
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CtNt T �c f�'o�
_ Windows/Doors
_Root ® Rooipfth
Building Height
Company:
Address:
Gly 7Al A! t i'llif State: F
Zrp Code. ID-Ir0 Far.
Phone No. �5
E-Maii'J�11V��L1�As,u,.
State or County License;
rs S25oo ormore, a RECDR®E® Notice of�msneoeement is required . '� � �
UI1:5I0IdER/ElMGINEER: _Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE
Name:
Address:
City:
Zip:
Phone:
— Not Applicable.
MORTGAGE COMPANY: _Not Applicable
Name:
Address:
City: State:
ZIP: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFI.DVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I. certify that no work or instaliation.has commenced prfoi'to the issuance of a permit
no
ermit holder to build the subject structure
covenants that may restrict or prohibit such
it 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 buildingpermit 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 pfoperty. 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
STATE OF FLORIDA
COUNTY OF-
The fo going instrument was acknowledge before me
this}dayof ZO by
:S, Q Mk a Cl OU rn)a • .
(Name of person ac n wledging)
(Signature of Notary P li' c-State of FI t'da )
Personally Known X, OR Produced Identification
Type of IdentificationPrpFiraad - -
hI
Commission
STATE OF FLORID
COLINTYOF_�( I(,'A
The for oing instrunli�ept was acknowledg before me
this'z day of MCW 20ti by
C� I i h,0 Aco
(Name of person acknowledging)
�I � /4 .
(Signature of Notary Public- State of Flori )
Personally Known X— OR Produced Identification
Type of Identification Produced
Commission
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