HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �o �. /.l SCANNED Permit Number:
BY
St. Lucie County
• Building Permit Application RECEIVED
Planning and Development Services 8 ?�t5
Building and Code Regulation Division JUN
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:
Property Tax ID #: 3Sj 22 ^ 6,O10 3 9 - o00 - a Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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HVAC _ Gas Tank
unuerinls permit— cneCKaii
[]Gas Piping
apply:
_ Shutters
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Windows/Doors
Electric Plumbing
Sprinklers
Generator
0
Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 02, 781, Lk
S Ft. of First Floor: _
Uti lities:Sewer Septic
Building Height:
OtNNER/LESSEE
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,GONTRACOR'S�
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Name: Richard Charlton
Address: '142oS. Oror l
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Company:
City: 7oyz W &AJ)
Zip Code: Fax:
Phone No.
State: mil,
Address: 16585 106th Terrace North
City: Jupiter State:FI
Zip Code: 33478 Fax:
Phone No. 561-339-7110
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: Richard@palmbeachwindow.com
State or County License: CBC059351
ii vaiue or construalon is yznuu or more, a RECORDED Notice of Commencement is required. L/\ u I i I
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DESIGNER/ENGINEER: _
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone:
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER: _
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 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 fir ' Ion. yo end to obtain financing, consult with lender or an attorney before
comm FIR work or recording vour Notice of Commencement.
_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA ,
COUNTY OF S'i . (• Oe 1 R
The forgoing instrr ent was acknowledged before me
this°k dayof J L)AR . 20 -by
STATE OF FL IDA'In
COUNTY OF 1 Y1 Y 1
The for oing instrume t was acknowledged before me
this�dayof20 Ulf by
(Name of person acknowledging)
(Signature of Notary Publ'e-State of Florildeptlo
) ra�sv"S E�iGe f Notary/Public-State of FloridaPersonally Known OR Pro uced (b�oe;$a�
IQ
nown V OR Produced Identification
Type of Identification Produced— L ac ae" e' of Identification Produced
Commission No. fQ S�1 `D (SefR}a oFF sS� �Na�� Commissio N
, , �ausiq°•"•o,Qt`� Oo��spp9 „ ,,,
JACQUELINE CASALS
'-_° • •_'- 0 ; Notary Public - State oFlorida
Revised 07/15/2014 �kg` •d My Comm. Expires Aug 10. 2015
". %',,;eo, ,,o?` Commission # EE 120800
REVIEWS
FRONT
COUNTER
Z A NG
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
MANGROVE
REVIEW
VEGETATION!
REVIEW
SEATURTLE
REVIEW
DATE
COMPLETE
INITIALS
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