HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED j�
Date: .�• �i� %7 - Permit Number: , 0�Ar/o
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 III
I PROPOSED IMPROVEMENT LOCATION: III
Address:
Legal Description: , X1,0 0.33G ia'PJ e_iM- A) /D5 a,4 zz„
g 9de)�
Property Tax ID #: 5 a 2 7 3 D 8 " ✓� Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: III
CONSTRUCTION INFORMATION:
itiona work to e e orme under tispermit-checka apply:
11HVAC �GasTank OGasPi. - in _Shutters ❑Windows/Doors
11 Electric 0 Plumbing Sprinklers 11 Generator 0 Roof
Total Sq. Ft of Construction: _.2 , '2 J_
Cost of Construction: $ /li D PJ , D ,P)—
Sy �Ft. of First Floor: _
Utilities: ll Sewer 0 Septic
Building Height: / "7 %
OWNER/LESSEE:
CONTRACTOR
Name
Name:
- age -
Address: 5CJ
Company:
City: o' ZMC-G State:
Zip Code:3H 9 � Q" Fax:'
Phone No.
Addressss:,3 /�
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City: �Z,
Zip Code: Fax:
Phone No. 7 7a - HGy
State % r
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E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: V6 N
4,4, SyzRG . V 0
State or County License: .6701ppz
4,
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/MINEER-
Name:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: �h ,
Address:
City: SJ Zo 6
Zip: 33�_ Phone:
ate: _ _ v .
9$-1 i/— 3 i f33
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
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 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 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
��t�lbsaE e�� IQG6l•�i
_ re natuof owneri fessem/Agent
STATE OF FLORIDA,�— p
COUNTY OF —h-i - LAY,�
The forgoing instr en was acknowledged before me
this., ay of V=.� . 20 K.by
P,6rsonallv_9a6wn OR Produced Identification
Notary Public State of Florida
Trade L Lamb (Seal)
My Commission EE 159114
Expires 01/25/2016
Revised 07/15/2014
�— S
Signature Contractor/Licens older
STATE F FLORIDV
COUNTY IF • f� r. o
The forgoing instru ent was acknowledged efore me
this � day of �2t! 20 _ by
PeurenelhrKrroVrn OR Produced Identification
Mr Commission EE 159114
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