HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
SCANNF-D
BY
- Lucie offill RECEIVED%,
Building Perm Appipica ion 1.
I
Planning and Development Services JUL 2 3 � 205
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 PERMITTING
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial >z Residential-.;t I unle rat nq F, FL
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PRQP,P�ER'.1 MP;,F�QV�
M E NT" ll'
CA
Address: I z)qTq- 11601 5
Legal Description: 17-31 -fl �rT� 6W Czw&f !�ce_ r�n PJ _9,(e(:f5 156M;n
TJ_1A �:� -11, 4c, '31 !;ec- W �1!� zd r,11A 2co-C4 .41 Pog
PropertyTaxlD#: Lot No.
Site Plan Name: Block No.
Project Name: _L
Setbacks Front Back: _ Right Side: Left Side:
eme�te-& -7000 Al d1mr-'I -��46
kJW
!,I ''I I NIP 11111 1111,11,11 111
ECOOMO��&T&�U( &ULINI
.6 f �l Ii 11 1
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Additional work to be ne d under this permit -check all apply:
[, rme
0HVAC Gas Tank E]Gas Pipli Shutters []Windows/Doois
OElectric Plumbing []Sprinklers Generator 11 Roof
Total Sq. Ft of Construction: — I
Cost of Construction: $ _. ;4) 0 00 -
S Ft of First Floor:
Utilities-11 Sewer E]Septic
Building Height:
S
�,`GONTMA�OWT,,,
Name_N-<,1c�,,.56) Sck-42pz--
Name:
Address:-44-+ 75r%�IcX K-
-0-:600
Company:
city: IM, "'Z_ —_
State: T�f
Address: te(( 91r_
City: S�K 0� t- I
State: R.
ZipCode: Fax:
Phone No.
ZIpCode: 346iq� Fax:
Phone No. IWU
E-Mail:
Fill in fee simple Title Holder on next page (if different
E-Mail: 1—!5+r V� -Jae�
p�k k-" I �e C oy'�
State or County License: I I o +!5
from the Owner listed above)
If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER ENGINEER: Not Applicable
Name: TD-'542k
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
City: State: F-f.
Zip: _]�� Phone: I - (�-73�
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER: Not Applicable
Name:
BONDING COMPANY:
Name:
X_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. Lucia Court makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in co 171Ict with any applicable Home Owners Association rules, bylaws or an9covenants that ma estrictorpr hibitsuch
structure. Please consult with your Home Owners Association and review your deed for any restrictions yhich may apply.
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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
- Signature of 0%�ner/ Lessee/Agent
STATE OF FLORIDPr, - STATE OF FLORIQ&
COUNTY OF M b-k AI COUNTYOF t;�:ic5_0_c L4—
The f r ping instr=t w s acknowledged before me The forgoing
this Pxday of 2 0 1 5—>by this lo�- day
was acknowledged before me
-b,<— 20 VS by
tName Or person aCKnowieaging) iNameoT-p, m"Knowiea"ging)i
(5
(Signata—re of Not Public- State of Florida (Signat_u-rZ-crFNotary-F1`ubIic- Stat Florida I
OR Produced Identification
— 1?6—rsonalry-KnovAi_--� OR Piroduced Identification
Commission No. 4!!M'4"-- wc Commission No. (Seal)
i.z Pffll!M�ay#3'0� 20172
EX
sowed Thru iZ�ry Pubibc 6nderwrAara BIE B. SABIN
Oil I FF 000
i��iw&-May 30,2017
59, ewf-F Banded Thru Notary Public Undem
.. ;.X�
Revised 07/15/2014
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