HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: A
SCANNED
"T BY
St Lucie County MAY -24 2W
PerrOftng
Building Permit Applications' W,"Iftent
Planning and Development Services county
Building and code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone; (772) 462-1553 Fax: (772) 462-1578 Commercial Residential -V/
PERMITTYPE
Address:
Property Tax ID #: (Do - C)[ 15 - OC) C)- Lot No.
Site Plan Name:
Project Name: Block No.
Additional work to be performed under this permit- check all that apply:
-I�Mechanical —GasTank — Gas Piping
%/Electric V*'Plumbing — Sprinklers
Total Sq. Ft of Construction: -35&0
. L -
Cost of Construction: $ C) C)
Name A&=H=ftdNwftwWFJgrkIa�kv.
— Shutters
— Generator
Sq. Ft. of First Floor:
Utilities: -v"Sewer _Septic
Address: aZl= GULLAW
city:!� y-yA,,W State:
Zip Code: -:52!965 Fax: 1552�9
Phone No._i—W _C154. CL�C)
E-Mail 14-3 V 2(5��-ttz3hcwte�. cam
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
City: Q)i
Zip Code:
Phone Nc
— Windows/Doors
V/ Roof _ Pitch
Building Height:
hl�-
— State: FT —
Fax: EGb.,934. S-5'33
E-Mail - k CCA"rl
State or County License MDIL16 -�yapro�,c R-
If value of construction is $2506or more, a RECORDED �Nofice of Commencement is rec
If value of HVAC is S7,SOO or more, a RECORDED Notice Of Commencement is required.
, R
SIOPPIECE E-,N1TfftMR9, -.;—I @ fffl qgi i
NSTJ T W
N
CIESIGNERIENGINEEK:
Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
Zip: Phone
City: tate:
—
Zip: _ Phone:
FEE SIMPLE TITLEHOLDER: _NotApplicable
BONDING COMPANY: Applicable
Name:
Name: —Not
Address:
Address:
City:
City:
Zip: Phone:
Zip: - Phone:
MAIRICI!11�^ �nA
�.. J wille nA%i UK ArriLivi I: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work dr installation has commenced prior to the issuance of A permit.
St. Lucie Coun I makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in conwict with any applicable Home Owners Association rules, bylaws or anscovenants 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 JOB SFIrE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDINC Yntip iiinTICIP nC rin,1111MCM,rceuer. -
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDAL-__—
COUNTY OF__ZN�,ITIer 4sia
Kz::� —
The fo[going instrument was acknowledged before me
this2adayof MgL�j 20B by
William Bryan Adams w
. fj�erlc,,
Name of person making statement
Signature
STATE OF FLORW�
COUNTYOF
The forgoing instrument was acknowledged before me
this93 dayof n-)CN 20__LC1 by
William Bryan Adami )
Name of person making statement
Personally Known �� OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
SHELLEYA.SEPULVED6 --I
My COMMISSION# GG 264g�4�-
EXPIRES: �anuary 25,20F%_J21F_,
Notary
of Notary
SHELLEYA. SEP
MY COMMISSION #
EXPIRES: Januan
Commission No. (462(-2c`714 (Seal) Commission No.!$&�25* (Sea[)
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