HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI , ., J
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ALLAPPLICABLE1 IOMtST COMPLETED FOR APPLI!,i�10% TO BE ACCEPTED
. Date: I (_�7 (3� Permit Number:
-Planning and Development Services Building Permit Application SCANNED
BY
Building and Code Regulation Division St. Lucie C0)jn1V
2300 Virginia Avenue, Fort Pierce FL 34982 VX
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: TO-Setezt4forn-dropbDr,-Cftk—.ffe��-
PROPOSED IMPROVEMENT LOCATION:
Address:— 150t) __r1rr-ArJ'J U09 PL
Legal Description: S-F I-V (,I C- 6-6�\J'
Property Tax ID #: 35ID3- DOD- 5
Site Plan Name:
Project Name:
-Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
I DETAILED DESCRIPTION OF WORK: III
S /&,Ljs i-j 0)
6 C, 4
[CONSTRUCTION INFORMATION:
1611 V1MLW WMELUI I I I�U U19UC1 LIII�PUI I I 11L-U11UL&d11 [ndpply;
0HVAC — GasTank E]Ga ' - Shutters
0 Electric' U Plumbing []Sprin*klers Elenerator
'Total Sq. Ft of Construction:
Cost of Construction: $ low
S Ft of First Floor:
Utilities:cn Sewer Else-
- ptic
I
N0,t;7,
[]Windows/Doors
EIRoof 8 1 4H
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name:
Company: S/ S19-Fl 0 AJ.S
City: (A M:�Cjb's D State: VL�
Zip -Code: Fax:
Phone No.
—
Address: T�_2-5" LAi � 1�� E �q w I
City: SOW) ?�A-7_br�/
Zip Code:. 3 S�Fg-
Phone No.
State:
Fax: /910)
/ VD0
E-Mail:
-Fill in fee simple Title Holder on next page (if different
'ircitin the Owner listed above)
E-Mail: - 7AC-KA;),S'16-JJ��20
)�JS_C�D is,
State or County Licer6:
/2-D D I I Ig-
ir vame or consimuion is �,&)uu or more, a RECORDED Notice at Commencement is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW Mrf OkOMATION- 11
IJt:5IFjNIt:R/ENGINEER: Not Applicable
Name:
Address:
City: State:
Zip: — Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
— Not Applicable I BONDING COMPANY: —Not Applicable
Name:
Address:
�!Ly: City:
Zi , P I : 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
str ' ucture. 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.
Th e 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
irriproverneg s o our property. A Notice of Commencement must be record d d posted on the jobsite
!� an I
before the fi s in ection. If you intend to obtain financing, consult with e e r an attorney before
commencin o or recording your Notice of Commencement. y 17P
Signature of OahrALessee/Agent Signature of Contra rise —Holder
STATE OF FLOO�RRI' STATE OF FLO
COUNTY OF— COUNTYCIF
The re me
this ZZ
(Name of rson acknowlb�d
g
)ng
P19TMt[Fre of Notary Public- Sf ate of Florida )
P�rs onally Known —OR P od I�entiflcation
Type of Identification Produced.
Commission No - \,�sds ry Public - State of A
y min. Expires Mar 22.
Commission # EE 8775
Revised 07/15/2014 --
The f ing instr ent w acknowledged before me
this Toirlday of 20 L��by
(Nan' 0 of person ackn Od edging)
re of Notary Public -
Personally Known —CIR P ation"—�
"te of Identification Produced R=
No.
Notary Public - State Of Ficrida
COMMissiOn # EE 877571
Bonded Through National Notary As
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