HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 102• IV, S _SCANNED Permit Number: IS la . O X
BY
St. Lucie Count%,
- Building Permit Application
RECEIVED
Planning and Development Services DEC 1 8 2�15
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address:
Legal Description:ST• Luc;z (or,.rk-ns ?.S'$(,ILI6 L3( tC r-t of (,oT i'1- Le(. W
pa- L-enrwr�_ ()-O-L-esS 15wu . v` CIJb et�i T1hrl�
Property Tax ID#:'01-XSCDL-0SO-2- Lot No.
Site Plan Name: Block No.
Project Name: L-tc%�rN (L�- ca
Setbacks Front Back: Right Side: Left Side:
CJHVAC UGasTank
11 Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ _9500
.......... .......... rr.,.
Gas Piping _ Shutters ❑ Windows/Doors
Sprinklers Generator 1:1 Roof
S Ft. of First Floor:
_
UUtilities: Sewer�Septic
Building Height:
y -�'� .
;OWNER%LESSEE:'�.� '� r
CgNTRACTOR+`
� F,�„R'Fabrication
L° Inca;•; �„�;��; ; ,
Name t0 Vloft hC
Name: Russel Lumsden
Address: 34g9 Orct iX, el -0Yl\I`e
Company: RL Fabrication Inc
t`01
City: T{ x7 1 �1- LU.�� Stater
Zip Code: ' W59- Fax:_
Phone No. rn� - I ()
Address: 1391 NW St Lucie West Blvd suite 363
City: Port St Lucie State: FL
Zip Code: 34986 Fax: 954-783-0406
Phone No.561-202-7493
E-Mail:'OWQl'K @
Fill in fee simple Title Holder on next page (if differen
from the Owner listed above)
E-Mail: RUSSEL@RLFABRICATION.COM
State or County License: 26236
It value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
C,crrjirr ?,ovyx) TnnA 2 fin- blur
uo�wlmiunr Givanviaon: _ rvot Hppncaoie MORTGAGE COMPANY: " Not Applicable
Name: _ke,\,2_ 1 1kor� Name:
Address:'-L45 y*l S-t,^uT- Su:1-f- -3-06 Address: _
City: va-rz '�ah� State: �L City: State:
Zip: 3'x9-(0 0 Phone: 1- 9 �t -L-/ 10 C Zip: Phone: ,
FEE SIMPLE TITLE HOLDER: V Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
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, 1 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
of Owner/ Lessee/Agent
STATE OF FLORIDA I _ STATE OF FLORIDA„
COUNTY OF i 1� LI �✓T I V— COUNTY OF J ll l L-fits 11, l^
The forgoing instrument was qcknowledged before me
this n day of 1PCQ a PA/ 20I.S_by
�'l/r^ate
person acknowledging
($ Pature of Notary Public1SWre of Florida I
Personally Known OR Produced Identification
Type of Identification Produced
CYNTHIA iMARIE BEAN
Commission No. �QjfARYPUBLIC
STATE OP FLORIDA
Revised 07/15/2014 "Unw" Explres 4J20/2018
The forgoing instrument was acknowledged before me
i
this ]day of , J to _/ti.,irP,t 20 by
person acknowledging I
(Si6oature of Notary Public -State bl Florida I
Personally Known OR Produced Identification
Type of Identificati n Produced
Commission No.
Y PUBLIC
OF FLORIDA
Expires 4=0118
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