HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE k` PLETED FOR APPLICATION TO BE ACCEI ' nn�"
Date: = Permit Number: & 0 W • 0099
SGANNED
BY RECEIVED
i� 21 R- St. Lucie County
" f v Building Permit Application JUN 0 6 20%
PlannBuilding
and Code
Development Dices / LuciePERCoHNG
unty,
Building and Code Regulation Division I'// St. Lucie County, FL
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 ill
Address: lZ-btb —
Legal Description:
Property Tax ID #:4L-a J " s
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block.No.
DETAtLED'DESCR1PTIO�N OF WORK: �+ p
�IeIL
�/aC`i� `(�-l)��! �i001s like- toy �ikl' �>c7 0�
9e0.Cf a�Js . Lot lti, .123bb� I z�bg
I CONSTWcr WIN' FORMATION ' . ..._ , -„ -Ill
®HVAC OGasTank
®ElectricPlumbing
Total Sq. Ft of Construction:
.
Cost of Construction: $ _'700 0 • f mo
,nr• - a.na..n av �MYrr G�-'p��
Piping Shutters ®3rlCiarSata�sJDoors
inklers ®Generator ®Roof
5 Ft. of First Floor: _
Utilities:Sewer E]Septic
Building Height:
OWNER/LESSEE; !`r
CONTRACTOR:
NameS6-4kSAo &C,_Qo asvur, a. ¢
Name: Joni z-
Address:tt. _ t
City: Lo4X Sr • c,�� statea� '
ZipCode: 3 yg S o i _s:
Fax: 7la -331a - I r f cpq ,.,
Phone No. 7 1 Gviy "`
;Cotipdri ?1a�ley,4insa �t�»orJ
�r
Address:
•:,;.. z, j L`:
,Ci - t State: L
'Zip ode:v � f�� Fax: N f 4
Phone No. (tea) 370 - 9/ QG
E-Mail: cL. Cco
Fill In fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: g11C e- l�)zez
State or County License:
tr value or construction Is SZWO or more, a RECORDED Notice_ of Commencement is required.
IEN LAW
DESIGNER/ENGINEER: J Not Applicable MORTGAGE COMPANY: / Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: If Not Applicable I BONDING COMPANY: /Not Applicable
Name:
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 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 approyed plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applicatlons 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 fender or an attorney before
commendng-work or recording vour Notice of Commencement.
_ Signature of Owner/ Lessee/Agent afgnaypre of wnua"ol/uccmc numel
STATE OF FLORID STATE OF FLORIDA ;A 1 . , . , , I :
COUNTY 01. LttiC.l2. COUNTY OF ^) • LU
The forgoing instrument was acknowledged before me
this tay of MaA20 I jQby
IAM �A�SLL12_Q
(Name of person acknowledging)
The fo oing instrument was acknowledged before me
this trday of At )JUIE,�J20' _�by
person
(Si nature of Notary Public- State of FI a) (Signature of Notary Public- State of Florida } /
Personally Known OR Produced Idarrification K- Personally Known OR Produced Identification V
Type of Identification Produced FL L— Type of Identification Produced - • _ j
Commission No. 91 NFAiHER HIWRI 1111 on No No.
(Seal)"
WCOWASSION0 F942534 tm�w..,
_' vvwaec.� w ,.,, T.. I(AREN S. NIELSEN 11
Revised 0711512014
My Commission Expires
Juno 12, 2018
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
Gg
COMPLETE
INITIALS