HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST PE COMPLETED FOR APPLICATION TO BE ACCEF.ED
Date: SCANNED Permit Number:
BY
St. Lucie County
Building Permit Application
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
0
I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line I
Address:
Legal Description:
Property Tax ID #: 35A Q o -3 — 0 oA 9 , c)oc) Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: _ Right Side: Left Side:
onaiworKWoenerrormea
HV
Electric
unuerEmsperrn11—LneLKd11 dpply;
Gas Tank DGas Piping Mutters RiWindows/Doors
Plumbing [:]Sprinklers 1:1 Generator 0
Roof
Total Sq. Ft of Construction:
Cost of Construction: $ I (eu , !J6
S Ft of First Floor:
Utilities-11 Sewer D Septic
Building Height:
C ON RACTOR--, ... r
Name Robapt-E
Mortq)4
Name: Richard Chariton
Address: 0 U-2110-1
r. 6OLol 5
company: C-VXr%(- VA-C�)
City: U% fb_Qw�k
Zip Code: _��,Ll 9S Fax:
Phone No.
-State: _C-L-
Address: 16585 106th Terrace North
City: Jupiter State: rl
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@paimbeachwindow.com
State or County License: CBC059351
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER:
Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City:
State:
Zip: Phone:
Zip: _ Phone:
FEE SIMPLE TITLEHOLDER:
—NotApplicable
BONDING COMPANY:
—Not Applicable
Name:
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 Count makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in co Act with any applicable Home Owners Association rules, bylaws or an9covenants 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 th u intend to obtain financing, consult with lender or an attorney before
encing work or rmRcordina vo Notice of Commencement.
Signature of Owner/ Lessee/Agent
Signature
STATE OF FLORIDA STATE OF FL97
COUNTYOF COUNTY OF ftV_�
The forgoing instrypent was acknowledged efore me The forgoing instrument was acknowledged before me
thhR day of Q %� yN�Q 20 1 � by thisc2lclayof CLO,� . 2 0 _LI by
Une"r lia-i\ L\V
(Name of person acknowledging) (Name of person acknowledging)
Notary Publid- State
Personally Known - " OR
Type of Identification ProdRSW
Commission No.
%u--- - 0% t�y
ro
Notary
of Identification
OR Produced Identification
Notary Public - State of Florida
Revised 07/15/2014 My Comm. Expires Aug 10,
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
6s7TUR—rLE' "iANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
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