HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date ; /zq .- — ei 0)6-03-87
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By
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StLudeCounh/ RECEIVED
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Building Permit Application
Planning and Development Services AUG 19 2019
Building and Code Regulation Division gr, Lucie county, Permitting
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
Address:
Legal Description:
ft
Property Tax lD#: Lot No.
Site Plan Name:
Project Name:
Setbacks Front Back: _ Right Side: Left Side:
Block No.
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pe,; M,6 &i� , -/'U- ('/"-7 f 4 '51,,Pw V�10 �- 0101' 7n5 iatk AqOLIIIS / d5w4,j ,L, -fi 1 Y- 5,,-tP W
I.-CON4T LI(ridWiN
F _QR_MAT
AdditionalworKtobenertormed
OHVAC EiGas Tank
under this permit- check
E]Gas Piping
all that appli
0 Shutters
E]Windows/Doors
E�Electric 191plumbing
05prinklers
0 Generator
0 Roof Roof pitch
Total Sq. Ft of Construction:
5 Ft of First Floor:
Cost of Construction: $ 2 L-(11
5 / Z-- C4-`e) Utilities'll Sewer E Septic
Building Height:
,9WNERAIESSEt*
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Name Rwd,k lzfm pxji-,S
Name: Y1,0
Address: qqot AyeWi Lii
Company: f;-[Lt,,C6 Onn4iq,i
(• -"011
City: P!�,L, — State: FL
Address: IGII
_r,, SOIL 'F;Jy�
Zip Code: 3LM66 Fax:
-
City: Aciv
State: -
Phone No. (11DLm4m
Zip Code: 31(95)
Phone
-EL
Fax:
E-Mail:—
Fill in fee simple Title Holder on next page (if different
E-Mail,75e__rV;0f�7�mo(&P
)n 01!7/1
State or County License:
from the Owner listed above)
it value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
Applicable
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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 ancicovenants 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 record_ed and posted on the jobsite
before the first inspe0on. If you intend to obtain financing, consult with I der or an attorney before
commencine workzf recordine vour Notice of Commencement. /
as
STATE OF FLORIDA f���i STATE OF FLORIDA /,
COUNTY OF �� �� COUNTY OF �/ LW��-
The forgoing instrument w s acknowledged before me
this � day of J✓G7 20 _Lqby
f Yl(LJl /' lu)&
(Name of person acknowledging)
sq*MLm Nwspne mipepun ao�ado
£Z9Z'6ZNdtseildx9 i
Y N
a119Z£00#uolss1ww00 s
(Signature of NOOpMBuJIURNMate ofFR610a�
Personally Known OR Produced l entification
Type of Identification Produced
Commission No. 1#,`y.°b"i,� (SeallENNAL.FRANCO
_Nka_4 a Commission# GG 328779
Revised 07/15/2014
The forgoing in rumen was acknowledged before me
this day of di 20 A by
(Name of person acknowledgin Sum
:Sspvpuko Commission#GG328179
a a En'TesAVdl29,2923 s
(Signature oNWPuUW&W9fF& Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. Seal)
JENNAL. FRAI
nFl Commisslon#GG
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