HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
ALL APPLICABLE INFO MUST BE CO ,74- ETED'FOR APPLICATION TO BE ACCEPitu
Date: SCANNED PermitNumber:
BY
b_:—�. � `P'"' St. Lucie Countv R�CEN m
__-_-_ _
Building Permit Application OCT,0 4 2016
Planning and Development Services
Building and Code Regulation Division PEP,-•L , ' I N a
2300 Virginia Avenue, Fort Pierce FL 34982 ss St.buoy Ccur
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial n Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
PROPOSED IMPROVEMENT LOCATION: III
Address: ZD ( D J-C � yl- 5- LU L(.L- y vvi)
Legal Description:
Property Tax ID #: 134111
Site Plan Name: 1 YL- Xt'
Lot No.
Q- rt)IF f � LAIC (t Block No.
Project Name: 1 n (�_ J'k (Jl Cal .Q_
Setbacks Front Back: Right Side: Left Side:
I DETAILED DESCRIPTION OF WORK: III
CONSTRUCTION INFORMATION:
�itiona workto e e orme under tispermit-checka apply:
LIHVAC ] Gas Tank []Gas Piping _ Shutters Erwindows/Doors
Electric El' —plumbing Sprinklers 11 Generator � I R000f Roof pitch
Total Sq. Ft of Construction:
- J C / S Ft. of First Floor: [ C J 7
Cost of Construction: $ L&F -D 'D Utilities.. Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name —WE Z Lvt + Q,
Name: A011
Address: Uh- 1 rlf-v lur
Company: v
ev �vrc.
City: U W'- J'-LuGt.z State:
Zip Code: 3 L1 4 i2_ Fax: T
Phone No/. �� 7—�7 D q Z fe I
Address: W'7%"
b tS& Vj� �%5-'S
City: i j,(QG IIUJIAK State: P�_
Zip Code: ,�3Tw'40 Fax:'706- 2S 9-U'4
Phone No. rl a`j- Li 66-03.Ud
/
E-Mail: U CWL- P0'y4-S4-L4)CA-f.- • e-Fl^^
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: IA�AVj %r2.i P_r e a-Q% ° eOM
State or County License: GC 02-7291 R
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRU640h
LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _
Name:
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
State:
City: State:
Zip: Phone:
FEE SIMP E TITLE HOLDER: _ Not Applicable
Name: A.U. 2iIh A-Vtmn ,
BONDING COMPANY: _Not Applicable
Name:
Addregss: ShL JI a�
11 L—
Address:
City:j/tryl- r+- U/GI_t,
City:
Zip: 3;Jq'z Phone: -11L
310 `/Clef
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
improvements tgMr property. "0
before the first/InWection. If vottinvei
STATE OF FL
COUNTY OF
a Notice of Commencement may result in your paying twice for
"ommencement must be recorded and posted on the jobsite
ttt in financing, consult with lender or an attorney before
The forgoing instrument was acknowledged before me
this 4�L day of ��� 20/4-by
(Name of person acknowledging)
(SignaWKe of Notary Public -State of Florida )
Personally Known X__ OR Produced Identification
Type of Identification Produced
Commission No./ UE NL 4SOTi
lM �W
Notuy Public - State of Fbrklt
,-my Comm. Expires Now 15, 2019
Revised07/15/2014 t�,•?"
STATE OF FLORIDA jet I I I I L1I S
COUNTY OF .W
The for o]ng instr ent was cknowledged be ore me
this ��day of 20 L by
T Ed-&A"ejl
(Name of person acknowledging)
of Notary Public-State"of Florida )
Known t/ OR Produced ]der
Type of Identification ti
Commission No. T e
Notary ublli�iclI11- Slate o1 Flodda
My Co11APEVires Oct 6, 2018
Commission N FF 166330
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