HomeMy WebLinkAboutBUILDING PERMIT APPLICATION';;'
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: • 1NF— NO SCANNED Permit Number:
- - BY
St. Lucie County RkCEIVED
- Building Permit Application MAY 15 Y019
Planning and Development Services Permitting Departmont
Building and Code Regulation Division St, Lucle County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x=o=
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
Address:
Legal Description:
Property Tax
Site Plan Nan
Project Name:
Setbacks Fri
Back: Right Side:
Left Side:
Lot No. Ll
Block No.
, UUILIVIIO 1"U.M w W cJ w1 IJau wmv uua pcnuu—uicUn uu apply.
0-HVAC Gas Tank ❑Gas Piping _Shutters ❑ Windows/Doors
Electric 0 Plumbing Sprinklers Generator / Roof
Total Sq. Ft of Construction: S Ft. of First Floor: l ��
Cost of Construction: $ Utilities:Sewer Septic Building Height:
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Name
Name:
Addres :V-r9!!ECompany:
City: lf7 a'4 4 AIIA 0 State:
Zip Code: 33 /3 f( Fax:
Phone No.
Address: 141
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City
Zip Code: r33`//i Fax:
Phone No. 2
Statg-,-.Y
E-Mail�iPi "@ *MiL12,7= YEm
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
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State or County License: 6.ff9 • .
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If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUP I EMFN;iPAL CONSTRUCTION l!tN LAW INFORMfiTIONf:°
DESIGNER/ENGINEER:
Name: f o �S
tApplicable
MORTGAGE COMPANY: ),�j
Name:
Not Applicable
Address: u
Address:
City:
Zip: Phone:
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HO4 Ejt„
Name: i /j(
_Not Applicable
BONDING COMPANY: _Not Applicable
Name: AJ
Address:
Address:
City:
City:
Zip: 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
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 inspection. If you intend to obtain financing, consult with lender or an attorney before
of Owner/ Lessee/Agent
STATE OF FLORIDA ��}�P%' STATE OF FLORIDAS�
COUNTY OF ,/_e ( COUNTY OF
The;?rRping ins
tr ent w acknowledge fore me
thi day of C 20 by
of person
(Signature of Notary Public -State of Florida )
Personally Known Ott Rr c4,(d@ANfit`dffdf%b°�
Type of Identification P public Sta:o of FlotloE
Frances Donza 092440
Commission No. : My Cq , o GG
m,
Revised 07/15/2014
The forgoing instru " t was acknowledged efore me
this day of. by
(Nam of person acknowledg' g )
(Signature of Notary Public-State� Florida )
Personally Known OR Produced IdeOt
Type of Identification -PLO
Commission No.
092440
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