HomeMy WebLinkAboutBUILDING PRMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:_ZU-t9_ rz 11 ZOO SCANNED Permit Number: IS
BY
'St-LUcieCoUntV-
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 L,-' Residential
I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line I
Address:
Legal Description;
Property Tax ID #: L? q.2—;7— S'62- � 6 0(50- Lot No.
Site Plan Name: (!;-r4 A(b IPA 1) 1 A"e- 4 Block No.
Project Name: pra�m A ve-c-vo� Ceo ->5 I �;l
Setbacks Front Back: _ Right Side: Left Side:
-�') � o -1
U�N I J I
c�
'�'Q'v V\_
11HVAC Ll Gas Tank
1-1W
14 Electric LN Plumbing
Piping Ehhutters OWindows/Doors
nklers 11 Generator D Roof
Total Sq. Ft of Construction: to/4 / Sq. Ft. of First Floor: 1- 0 / !7�_ 7
Cost of Construction: $ J�p 00 - %j7l) Utilities: 0Sewer OSeptic BuildingHeight: �I)
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Name ClOe&cig C t
Name:
Address: ftW25-7,1' Clwl_,6c�
.'N' -�' - &V1 ov, M er-
company, e'Q 4 5: 100.
City: 1P. F4�1`1 State:
Zip Code: :ax:�
Address:
City: X�41 je� State:AC--
Zip Code: Fax: ?'72
Phone No. :7 '72-- �Al- 5&
PhoneNo. e7zz_ 15
E-Mail: Cl,(!5 &I-P'e) 9X wo�Sycg,*k,�
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: eok* 1 s-re_z 2
State or County License: C&,o / 5-49 q 2-,�7-0
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
C' & 0- 0 VVIN
TWON-SR01 10NINIENIA-MIN.FkORMATON
DESIGNER/ENGINEER: —NotApplicable
Name:
hddRTGAGE COMPANY: Not Applicable
- Name:.
Address:
�Wciclres�s:
City: State:
Zip: --Phone:--
City: State:
Zip:-_ Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
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 Coun makes no representation that is grahting a permit will authorize the ermit holder to build the subject structure
which is in co 1711ct 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 M ich 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
commencine work or recolVdine vour.Notice of Commencement.
4��getR- ,
Signature of Owner/ Les
STATE OF FLO STATE OF FLORID4 —,-
COUNTY OF. COUNTYOF,
The oing instrLnent was acknowledged-hefore me
this t�g day of 20 L\
0— i-by
person
Personally Known ,
Type of Identification
Commission No.
Revised 07/15/2014
Notary Public - State of Florida
My dM) Expires Mar 22, 201�
Commission # EE 877571
The forgoing ins ment was acknowledged before me
this 3 day of 20 by
A
E2 i:
(Name of person acknowledging )
I U
'(Signature of Notary Public- State of,Flolida )
Personal.1y Known _ OR Produced Identification
Type of lderitificatlore&ad=d—.�4� L
0 ... I.,. ... --
I)ANN MIL0`NEf
Commissi IN Notary Public - Statil[WAIda
MY COMM. Expires Mar 22, 2 017
01 -11)-
IRV commission I* rr 277.,.
J..���Iough National Nolary Lin I
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