HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLh-"FOR APPLICATION TO BE ACCEPTED
Date: /B PermitNumb.
V� 1
oV/-tIVIVtLJ RECE?VED
BY
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address: -S. u
Legal Description: 52c d ZG.
Property Tax ID
Site Plan Name:
51- Lucie Countv
Building Permit Application
Commercial _ Residential
Setbacks Front .so Bac Right Side: LeftSide:
OCT 17 2016
PEWITTING
St. Lucie County, FL
Lot No.
Block No.
r+aamonai worK zo De perrormea unaermis permit-cnecK au cnai appry:
_Mechanical ! 'Gas Tank _Ga's'Pip,ing _Shutters ; _)Windows/boors
_Electric _Plumbing _Sprinklers _Generator Roof
Total Sq. Ft of Construction: /.Z D Sq. Ft. of First Floor: ( !
Cost of Construction: $ 2QZ/ Utilities: —Sewer _Septic Building Hei ht: L
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Name /L P-R Ae"
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Name
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company; .'<'o /i'• e
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City PY�f G �;e
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�2ip`Code 352 '" 'Fax: -
City: 5-! Lws�
State
Phone No.?7Z 37o-/y6I7
Zip Code: .3VV5Z- ,
Phone No. 777— - 376—/gP7
Fax:
E-Mail: cia G (�cry�rvr2�n iNO .�oit +
Fill in fee simple Title Holder on next page (if different'
E-Mail: C,� c4>
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State or County License: Cf3G
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from the Owner listed above)
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
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MORTGAGE^ COMPANY: • Applicable
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City: f�La
• Phone:aI
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City: State:
FEE SIMPLE TITLEHOLDER:
Name:
• Applicable
BONDING COMPANY:• Applicable
Name:
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Address:
City:
City:
• Phone:
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OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
[.certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no
which is in conflict with an
structure. Please consult In
:e the permit holder to build the subject structure
or and covenants that may restrict or prohibit such
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, sighs, 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 vour orooertv. A Notice of Commencement must be recorded and Dosted on the iobsit
consult With lender or an
Signatu r1l6f Owner/ Age , essee Signatu6ff of Contractor icense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF . Ll ) Ci COUNTY OF . lug IE,
The forgoing instr ent .s acknowledged before me The fo..--rggoing instr en , as acknowledged before me
this —1--r- day of 20f�p by this L day of 20] to by
(Name of person acknowledging) (Name ofplerson acknowledging)
(Signature of Notary Public - State of Florida) (Signature of Notary Public -State of Florida )
Personally Known OR Produce Identification Personally Known OR Produced Identification
Type of Identification Produced L
" Identification Produced EL I)
At Commission M FF 1 5637
Commission No. ®011) My commission E pF2 slon No.
+ June 12, 2018 e � KAREN S. NIEL!
ioa° Commission # FF 11
REVIEWS I FRONT I ZONING
COUNTER REVIEW
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RECEIVED
SUPERVISOR I PLANS I VEGETATION
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