HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: tpZq 0
%�GANIVE[)
BY
st-LuciecourIty RECr-wEr)
Building Permit Application
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 X Residential
MAT 17 2017
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
,PROPOSED IMPROVEMENT LocATib'N-"1.
Address: 4 �a,7 6 0z5:6- 09AI 19-4:g? a- g�- IV 5 zF ry 62)g8e-2v
Legal Description: &,,-/ Z-4- iq 40,F.,' -,54o C,
PropertyTaxlD#: —,0c7o&,—cePo —45) Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: _ Right Side: Left Side:
,DETAILED DESCRIPTION OF WORK-.'
D
�- 1;�- 0 e, 0 "-
7 a z
CONSTRUCTION INFORMATION:
1-1HVAC L.J Gas Tank OGa
[JElectric 1:1 Plumbing 0SP
Total Sq. Ft of Construction:
Cost of Construction: $ -413 .5 0 - 0 C>
Piping L==! Shutters
nklers 0 Generator
S, Ft Of First Floor:
Utilities. Sewer 11 Septic
Windows/Doors
Roof = Roof pitch
I
Building Height:
CONTRACTOR:
Name 004-;5,:P,4 eaPIVAE>-
Name:
Address: J1,VcPc:1 j0,-",7
Company: 04:-7-g-'iZ 40 -e-cDr%.1
City: a"AXI State:Yfi-
Zip Code: 2 i6 ? Fax:
PhoneNo.
Address:
state:
ZipCode: 399? Fax:
PhoneNo.
41irri A,-,f4Ar-e-A iWV, e
Fill in fee simple Title Holder an next page (if different
ftom the Owner listed above)
State or County License: C &14: -"/o 33
It value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Name: &�_jPC-A(Z 0"_97A;J95
Address:Y.ko tv. jl�-XO 1j4w
City: /_ Wt-:� rX W,0 0Z TW State:
Zip:,53soe-e.ev- Phone:6r5r-!T9?:5-56T'4_
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY'
Name:
Not Applicable
Address:
City:
Zip: Phone:
State:
BONDING COMPANY:
Name:
—NotApplicable
Address:
Zip: Phone:
I certifV 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 ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or ang 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
commencine work or recordirie your Notice of Commencement.
as
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Si4. luc,ito- I COUNTY OF IA�6iekl
The for Ing instrument was acknowledged before me
this irday of Play 20 aby
(Name of person ackriowledging) /7d- ei-P.
(Signature of Notary Public- State of florida
Personally Known L--*/ OR Produced Identification
Type of Identification Produced
Commission No.EEORL 1.0 Not�a=yP.bl,.St-t-
RhondaCBielefi
The forgoing instrument was acknowledged before me
thisAILItayof Ao>- 20 Zn_ by
Pq D &AR�A-7_ :�; 7_Aq K
(Name of person acknowledging)
(Signature of Notar/Piiblic-&tatof Florida)
Personally Known — OR Produced Identification
Type of Identification Producedr& 5 362 96ke!�"F_
No. 66 0939 L( (Seal)
1� MYCOMMISSION#GG073704
Revised 07/15/2014 '- wwi�- ENPIRES: FEB 15, 2021
W" Bonded through Ist State insurance I
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