HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONC..
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �ro1o� �, SCANNtL Permit Number:
BY�OVE®
St. Lucie Crn
Building Permit Application MAY 22 7flt
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
V
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED,I M PROVEM ENT LOCATION:
Address: / P7 ? 0 . ,
e5_1 `, A, 5-Y,7 ,2 S
/
Legal Description: eo
Property Tax ID #: So —sw
Lot No.
Site Plan Name:
Block No.
Project Name:
Setbacks Front Back: Ri tSide: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION IN
r.uwuonai WVlRcoue enurrneu unaercnis perms—cneeK an apply:
�HVAC Gas Tank EJGasPiping _Shutters
ectric 0 Plumbing []Sprinklers Generator
Total Sq. Ft of Construction: _:&
Cost of Construction: $ c255 5,9 .O d
5 Ft. of First Floor: _
Utilities:Sewer Septic
Windows/Doors
11 Roof
Building Height: / G . 90
OWNER/LESSEE:
CONT A OR:
Name
Name: y
Address:
22
Company' W oj�ic
City: Y Cc.e� State: _
Zip Code 95 a- Fax:
Phone No, 7- 2 'Z g Jr 3
A
Address: 3 7 L,P� r
City: ;6.-_ Statg7�
Zip Code:.:�Wy(,e Fax: 41/r90-?I67
Phone No. 772— ws'
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: 9S/ti A15 ,Jy r
State or County License: # ?55 y .0
If vame or consirucrwn is>cauu or more, a ntLunutu Notice
Is required.
!/
SUPPLEMENTAL CONSTRUCTIONLIEN, LAW INFORMATION:
DESIGNER INE _
Name:
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
9
Address:
City: g-C�c�
Zip: Phone: —e
State ✓
1 �'l
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 County makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or angcovenants 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
commencing work or recor Ing your Notice of Commencement.
_nature of Owner/ Lessee/Agent Signature Contractor/License Holder
STATE OF FLORIDAC 1j_ STATE OF FLORID'
COUNTY OF JIT , COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instr ent was acknowledged efore me
thls day of � 201�by thiday of � . 20 ? by
,Personally K n OR Produced identification
entification Produced
Commission No.
�sW 'ue� Notary Public State
^ Trade L Lamb
S _
ar Fo ?Expires0l/2512016
Revised 07/15/201 _ ,,
Florida
ferso n OR Produced identification
Type of Identification Produced.
Public State of Florida
01125/2016
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