HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: 544 /4110 -Oe
BY CEUVED
Building Permit A�Olil&Qlfflty
Planning and Development Services AUG 30 2016
Building and Cade Regulation Division Public WOMO
2300 Virginia Avenue, Fort Pierce FL 34982 SL Lucie counlys FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ✓ Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: Ff! 10 s 04- T nab s` L Uci e
Legal Description: C-ozv eA 2e cr C7'046! 6L rj /I /0-11' 2/ ?0 4'c-
i
Property Tax ID #: ?y / 1 - 5C7 l - l 9 /.S - / 6010 Lot No. is
Site Plan Name: R17CE79//C M/7/tK.C- ova- 11J4 Block No. 3
Project Name: RgC.C- 7/L/9 c
Setbacks Front IBack: Right Side: Left Side:
DETAILEDDESCRIPTION OF WORK: I
1/3IJ-f,1 -L L quvY
CONSTRUCTION INFORMATION: III
OHVAC U GasTank
OElectric 1:1 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 3 gj,doa
Piping
❑_Shutters
❑Windows/Doors
nklers
11 Generator
Roof
=
Roof pitch
S Ft of of First Floor: _
Utilities: L� Sewer ElSeptic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name RACE T%t,9C 6E7',001-EIim
Name: AlIck Y AlE/vn/
Address: 4 a Y yE _129eP-
Company: S-C ciT/l.E2n/
TaQQ;r971 av Tivc
City: 14%LAv3A State: _&
Zip Code: an 1031 Fax:
f
Phone No. ' \J a �3 C�� _
Address: S 1 0 7 rai
A7o0c2 cr JT.
City: /1� LM
Zip Code: 141 7 9 ci
Phone No. `77.. - 2 8a -
State: �L
Fax: 772 ?88 i8S r!
/BS3
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: Sag-e4 P..~ i /•yr a7 ' 64,11ro4 e4-. e T
State or County License: / I"
If value of construction is $2500 or more, a RECORDED Notice or Commencement is requirea.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Name:
Address:
City: State:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
_ Not Applicable
FEE SIMPLE TITLEHOLDER: _ Not Applicable 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 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 recording vour Notice of Commencement.
STATE OF FLORID COUNTY OF Z u_G1
The for ping instrumepnt was acknowledge before me
thisay of 20 y
a,y,
(Name of person acknowledging)
Type of
Commission
Revised 07/15/2014
s
Signature of Con for/License Holder
STATE OF FLORIDA
COUNTY OF fir_ n
The forgoing instrument was acknowledged before me
this_�OdayofPjl.MU-9�— ,20 by
ffy- (_ S . ocnin
(Name of person acknowledging)
Type of Identification
Commission F 134730 Commission No.
Lomm. ExpiM's� 27, 2019
ded through National Notary Assn.
Notary Public . Stale of Florida
My d&f?A0Expires Mar 26, 2011
Commission # FF 002136
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