HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONY %r
ALL APPLICABLE INFO MUST BE CO L FOR APPLICATION TO BE ACCEPTED
Date = 5. - - __
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r — - — - ermit Number. \ �5
_ BY RECENED
' St. Lucie County
_ Building Permit Application MAY 17 ?Gt9
Planning and Development Services
e Geuntyr pormlttln9
`Building and Code Regulation Division ST. Luclee
2300 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 M, V%
PRQP�05ED _MPRQVEMENT LOCATION: -
Address: &E
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Legal Description:����((�,, 1���,y�(y,Q. L 9�j
Property TaxIDN:���� -rn�f3Ul'{�ili-� LotNo.543
,
Site Plan Name: Block No.
Project Name
Setbacks Front Back: Right Side: Left side:
ton, SEER, =-; ` G -°,;-
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CONS iRUCTiON INFOR ATION:
,Acldltional work to e e orme •un er-t is perm -c e. a app r--
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OHVAC �GasTank ❑Gas Piping
_Shutters Windows/Doors
❑Electric
Plumbing ❑Sprinklers 11 Generator ❑Roof Roofpitch i
Total Sq. Ft of Construction: 5 Ft. of First Floor: '
Cost of Construction: $ Y U[ilities:115ewer septic Building Height:
ZWNEMTESSEE '," .h "" ]
G(ONTRAC-iOR: -
Name
Name: DennisZicek
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Address: �s_1/yZ� lo`. ,)(• -
Company: ARS American Residential Services
City-Vnca-:`�R-
.P. State:,E-
2800 US HV+Y 1� Address:
Zip Code: 3y451 Fax:
City: Vero Beach State: FL
Phone No.-b-6-YG24 _(hZlolI
Zip Code: 32960 Fax:
E-Mail:
Phone No. ��c1-�4t-} •� aQ�3
E-Mail: U\V rk)O.t\A00.CS -Core%
Fill in fee simple Title Holder on next page (if different
State or County License: CMCl249753
from the Owner listed above)
If value of construction is $250D or more; a RECORDED Notice of Commencement is required.
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SUPPLEMENTA CONSTRU « IION LIEN W NF
RMATION: �;�,Y,�
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:DESIGNER ENGINEER:""`-`-X NofA liable `iz
,: — pP —
Name:
_MORTGAGE COMPANY: Not Apo icable=-=ti
Name:
Address:
Address: u
City: State:"
Zip: Phone:
City:
Zip: . Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY: s Not Applicable
Name:
Address:
City:
Address:
City.:
Zip: Phone:
Zip: Phone: i
s
I certify that no work or Installation has commenced prior to the issuance of a permit.
St. Lucie Count yy makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which Is In confllct with any) applicable Home Owners Association rules, bylaws or an9covenants that may restrict or prohibit such
structure. Please consult w th your Home Owners Association and review your deed for any restrictions which may apply. -
Inconsideration Of the granting of this requested per it, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Bu Iding Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessorystructures, swimming pools, fences, walls, signs, screen rooms and accessary 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 pasted on the jobsite
before the first inspection. If you -intend to obtain financing, consult with lender or an attorney before
comme�:work OF recordmi< Vour Notice Of Commencement.
•,_Signature of O er/ Lessee/Agent s
:STATE OF FLORIDA
{ -COUNTY OF st"
I
E . The Nigoing Inst ment as acknow edged before me
this day of 20 $by
Cumis zark
_ Personally Known x OR Produced Identification
iType of Identification Produced
rr
Commission NotJ..-ti �J�(Seal)
Revised 07/15/2014
COLEEN
OF FLORIDA
TYOF
going ins tru ent s acknowlecig efore me
day of 20 by
person
rnally Known x , OR Produced Identification,
of Identification Produced '
1.
nission No.C-{1MNER5b (Seal)
i Fobniery 09, 2027 �; li
MY COMMISSION R 00071535
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