HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONIt
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: j `yCBy ED Permit Number:(
n; 3t. Lucie County RECEIVED
Building Permit Application MAY 2 2 2015
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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: /—P/ 7,,V � /GP I V, All �cu
Legal. Description: A4e, ly / -) `l q D Y-t>.44 Al Ybeg 22 ` %Agt'e Rlm )
Site Plan Name:
Project Name: l/i1sJ 2c� fLeO�c
Setbacks Front Back:
Right Side: Left Side:
Block No. "4
DETAILED DESCRIPTION OF WORK: III
CONSTRUCTION INFORMATION: '111
nivnc�vvvinwuc mwn ncu unueIuna Pernm—urccrt an appry:
❑HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric ElPlumbing ❑Sprinklers ❑Generator ❑Roof
Total Sq. Ft of Construction: 5,7)
Cost of Construction: $ :2- 5 e , O-2)
S FtFt.I of First Floor: _
Utilities: Ll Sewer ❑ Septic
ni
Building Height: 42--
OWNER LESSEE:
CONT ACTOR:
Name U �
ame•
Address: e;(p. ('
�q
Company:, (AA,
q
1 r Vied r
City: 1�btZ�f . YltO L0 State -a,
Zip Code:g#C) 5'� Fax:
Phone No.
Address:3
�J
City:'J� lahc-c State.—1
Zip Coder di a Y4 Fax: 464 - �1 /.S 7
Phone No.`7) ? - '164 " O 71V
E-Mail: r
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: S/G ldig 30
NE7
State or County License:6�1s
6 47D h e a /.57
it vame or construction is pabuu or more, a atwnueu ivotice of commencement is required.
SUPPLEMENTAL STRUCTIONUEN
LAW INFORMATION:
DESIGN& ENG NEER:
Name:
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: aoa yl
9� 2ve?
Address:
City: Y-J,a e;r
Zip: 33 8 Phone: /-
0 State:
S -d / 3 i/
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 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
_ Sigoture of Owner/
STATE OF FLORIDA )
COUNTYOF�f„�
The forgoing instrument was acknowledged p efore me
thisday of 2015 by
It
person
Commission No.
Revised 07/15/2014
OR Produced Identification
1TPublic ate of Florida
5aL'I L Lamb
My Commission EE 159114
Signature Contractor/License older
STATE F FLORIDA
COUNTY OF Sk t o.
The fq[going instrument was acknowledge'd` yefore me
thisy_ day of 20 1.)- by
�\ eir
O�Yr�O�
(Name of son acknowledging)
(Signature of Notary Pub ic- State of Florida )
M
OR Produced Identification
EE 159114
,
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