HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �l �—
Date: Permit Number: jsv3- �/�5 7
SCANNED
Building Permit Application- Lucielcoar
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: GZtan�k, j
P,RbOd5E' IIVIP.,ROVEMENT LOCATION:
Address: 1103 Tilton Road Port St Lucie FL 34952
Legal Description: St lucie gardens 23 46 40 blk 3 lot 4-less s 10 ft and less rd r/w
Property Tax ID #:3414-501-0704-000-3
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side:
Left Side:
Lot No.4
Block No.
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wIN w v��u Un IICU wwo uiu pcnnu—uie6n au apply:
❑HVAC I 3as Tank ❑✓ Gas Piping Shutters ❑ Windows/Doors
❑Electric 0 Plumbing Sprinklers Generator ❑ Roof
Total Sq. Ft of Construction: 1 1 S Ft. of First Floor:
Cost of Construction: $ 5.0 2 g q Utilities:n Sewer ❑ Septic Building Height:
Name Y
Name: Di0 \n
Company: *l Y
U c i \ C.
Addr s: 4r
City: Stater
Zip Code: , N Faxr:
Phone No. MA - r�A InDJ
Address:
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City:
Zip Code: q
Phone Nai. -
State:_
22 Fax: o S�QS
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E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:qtft00bbY((
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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"F4f,LEMENTALCONSTRUCTIONI IEN LAUD INFORMATION: iV.Xu- -.maw
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City:
Zip: — Phone:
State:
City: State:
Zip: - Phone:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
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 Court 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
commepcing work or recording vour Notice of Commencement.
i v v v s
_ Signature of 0 ner/ Lessee/Agent Sig ature Contractor/License Holder
STATE OF FLORID / _ STATE OF FLORIDA
COUNTY OF COUNTY OFsamtw=ie
The f r ing instru nt was acknowledged efore me
this aday of 20 15by
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
Revised
N013iy Pr le of Florida
Antoll, a ,b,00,1a
My Comm4ssswn P� 191201
The forgoing instrument was acknowledged before me
this 17 day of March 20 _by
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No.
Expires 02/27/2019
of
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