HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /. / r • �� Permit Number:
SCANNED
Building Permit Application BY
Planning and Development Services St. Lucie Count
Building and Code Regulation Division
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
PROPQSED.INIPROVEMENT LOCATION `-.: _ e�`?
Address: S?S-D S ncklbJ 7(G(Jr (0,9 40rK(2A-L
Legal Description: ISLA�iO JlAJnrE-S C0N0006tIN(UNt 4 WAOr %33 Aj-IZIA-
Gr✓Iirr f&Aft, LIU iw,Wff//VIVI" 6yr& Ii2 rb -flip 1 / 1-rV u -/0
91
Property Tax ID #: 3S 3S -foo - O2.7D-Coo - Z �Lot No.
Site Plan Name: -re ik4 A- 'riS w Block No.
Project Name: -i6AN A r 70vt o
Setbacks Front Back: Right Side: Left Side:
S 96X is (
S�TT�
(z� pvl rrt-s, -rSl. N �- sN A--�n.>•� -� 90%/�3
[.CONSTRUCTION INFORMATION,=®
Add nionaI work toofelerrormeo un ert is permit- check all apply:
❑HVAC —Gas Tank ❑Gas Piping _Shutters Windows/Doors
❑Electric ❑ Plumbing []Sprinklers ❑ Generator ❑ Roof
Total Sq. Ft of Construction A114- S Ft. of First Floor: 6✓IA-
Cost ofConstruction:$ 9,W7 0cD Utilities: Sewer❑Septic Building Height:
OWNER/b,, EE �
CONTRACTOR:
Name r-TglktJ 4 rn.12rzAe)�^
Name: AAtr H y- &e--poiyi/A�,�
Address: 97yiii CQ ceA-Y)a, (-9-3
Company:apgcet I?td* -I r((Lfi9/NUM
�
City: ?cnl ftr� 17C2�7i1� i State: iti
Zip Code: 3 �t S r7 Fax:
Phone No. -15
Address: 11(, r 7tlkFt= �
_(���
City: Sh A2tState: K.
Zip Code: 345gy Fax: �q?--1r'i9NY
Phone No. CC2-97NY
E-Mail: N.n
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: &/Z (n6Q Or//n C' yaml erxn_
State or County License: r%e,
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
xSUPPLEM' "LtONSTRUCTIOkLIEN LAW INF,'ORMATION
DESIGNER/ENGINEER: _
Name: S 4211 Mo r•o oar
Not Applicable
P.E
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address: 13630 5 ►Jor-4M
teu e_ lot
Address:
City: CRArwaley
Zip: 331Loo Phone: —Id"t -
State: iL
531 •90oo
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _
Name:
Not Applicable
BONDING COMPANY:
Name:
Not Applicable
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 Countyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contlict 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 f ' ure to Record a Notice of Commencement may resul in your pa ' g twice for
improvements to yoyy� prg� ty. A Notice of Commencement must be recoydecjnd po on the jobsite
before the Wst jns cti you intend to obtain financing ns It tith n t rney before
Signature of Own r/ Age / essee
STATE OF FLORIDA II
COUNTYOF fl Q-rinI
The f $bing instru ent was acknowledged before me
this day of th 20 3 by
of
Type of
IS991 N I u0lsglwwo0
Commission No. S10Z •Sl aoN sa ldx3 •ww(gp&
eDP01i la ale1S - ollgnd ARION
Revised 07/15/2014
STATE OF FL
COUNTY OF
The f ing instru�it�nt was acknowledged before me
this, day of(`}ftU 20 % by
(Nam
ledging I
(51 ature of No
ry Publi ate of Flon
Pers Ily Known
O P c I ificat' n
Type of I en
Prpdu;,g. ,,,,,.� «.,.,..
Notary Pu
IC -r� tale of Florida
Commission No.
•= y Comm.rE',�4
Nov 15. 2018
Commission ar FF 165316
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