HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number: 1��0.iow)
BY
•., St. Lucie County �E
Building Permit Application OCT y 2`2017
Planning and Development Services
Building and Code Regulation Division St. LucieMC ul G
2300 Virginia Avenue, Fort Pierce FL 34982 r, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
Address:
Legal Des
Property Tax ID #: 3S .R Q — 6 002 - 00 10 ^ 000 ^ 3 Lot No. -
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILEDDESCRIRTION,OFINQRK
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CONSTRUCTION.INFOBMATION
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-HVAC Tank
unaercrosperma— cnecKau
❑Gas Piping
appry:
Windows/Doors
_Gas
_Shutters
Electric
El
Plumbing
Sprinklers
0 Generator
_
Roof
=
Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 1`t Utilities:cnSewerE]Septic Building Height:
OWNER/LESSEE
CONTRACT R
Name
I C
Shau)
Name:
Address: 46 Pitillyi�tr FpoyrA d
Company:CfiRLGTOI✓ �e0?s��(S/�C'•
Address:/65uSS/0(o7/ %E.CC/dfCf/OCTf/
City: State: '0":2—
Zip Code: SS 418 Fax:
Phone No. 57&7 — '1✓3`�—�/l�7
_
City: E(1St Nart' Cork_ State: C l
Zip Code: 06 II a Fax:
Phone No. ($60� 214,— 2116
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: ee o7
State or County License: �,dC Oj 93 S/
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
, . .
SUPPLEMENTAL' CONSTRIJCTIONLIEN
LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
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 Count yy 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
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 er eTcordI L- vour Notice of Commencement.
as
STATE OF FLORIDA
COUNTY OF
The fae#Wg instr nt was acknowledged More me
thisC.S day of v'�' 20 Lrby
STATE OF FLORIDA
COUNTY OF
The for QI'pg instrument was acknowledged before me
thlqday of �a//,C , 20 / 7by
117_�rhoi d C &D( Q�r�rd cywl�ta)
(Name of person acknowledging) (Name of person acknowledging)
1hJ'i0 ,444Z&i:L
(Signature of Notary
Public- State of Florida )
Personally Known V OR Produced Identification
Type of Identification Produced
Commission No.
MELISA ARMENTO
Revised07/15/201 i' roa EXPIRES:December 28,2020
P.••
4,ui tq.• BOMetlTw Notary Pubic UndenYfiters
(Signature of Notary
-Public- State of Florida )
Personally Known V OR Produced Identification
Type of Identification Produced
Commission No.
MELISA ARMENTO
EXPIRES: December 28,2020
Baled TNu Notary Public UMewiters
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