HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONra
ALL APPLICABLE INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date'-,? ' -31 " % SCANNED Permit Number: 11DJ N l
BY
Em
St. Lucie Countv
Building Permit Application 06
Planning and Development Services op'"
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Renovation
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: 4/0'e4I- C,"n C'o "r s��CJ 7i/ A' 3(0 !/ D
Property Tax ID #:
Site Plan Name:
P
Lot No._
Block No.
Project Name:
i
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
-e' .Veo-
CONSTRUCTION INFORMATION: III
t+oa1L1u11d1 worn w ue enurmuu unuer uun Pennu—urecrt du dppry:
Rectric
Gas Tank ❑Gas Piping Shutters Windows/Doors
Plumbing Sprinklers FIGenerator Roof
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Total Sq. Ft of Construction: J% Sq. Ft. of First Floor: rr
Cost afConstta ...$ �A�— Utilities: 5ewer�Septic Building Height: �e
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OWN_ ER--L•E6�SEE� _Q/G��
CONTRACTOR: v
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-Nam � ��_ n . _ - _ / _ D/.% _
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Name:--GlT�1=G 5�17 /L7
_
Address: J - '
'Company:-6 fA'Vfj¢1, S /'q /per
City: Stater
Zip Code: _ ax
Phone No AZ Fi Zr -6 ..� _ ,
Address: Z W -ff
City: mod!✓ State: C i
p�-P6
Zi Code: �l Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: W R ae�9"YA C / la-9
State or County License: G GJ /C 00 04P lo4
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I
ueawtvrn�rry mrrtt: _ No Appncaole MORTGAGE COMPANY: I/ Not Applicable
Na IT
dlC� S`J v Name:
Address:2�Y� P �U / Address:
City: 9 �[Q State City: State:
Zip: Phone: 'Z Zip: Phone:
FEE SIMPLE TITLE HOLDER: t/Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
Applicable
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
TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
.nits to your property. A Notice of Commencement st recorded and posted on the jobsite
figpection. If you intend to obtain financing, orr upyrRt(t lender or an attorney before
_ 5gn�fu e f wn r{/ Lessee/Agent
STATE O F ()/Q��
COUNTY OF. ./� '
The fo ing instru/rp��nt� was
this day ofipl^'
person
Known
dged be ore me
20 8,by
STATE O RID I
COON y �2JI�
The forgoing instrum�jnt was acknowledged before me
this day of 20 / by
of
Known
No.
Not y
-is- o's UAWN MILONE
• �e Notary Public -
Revised 07/15/2014 =y' '' • '? My Comm. ExpirestMa of Florida
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