HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLIINFO Mrj� Gnru;LETED FOR APPLICATION TO BE ACCEPI'.��
Date: I � Sr.'ANlhllz1' Permit Number:
BY RECEIvED
St. Lucie Countv
Building Permit Application NOV 3 0 2016
Planning and Development Services
Building and Code Regulation Division Public Works
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County, 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
i.-PROpn-,;FnIMPRnvpmFNTinCATInN-
Address:
Legal Description:=L� 4a_�519(1 - OW�= I &*Juns /-T Rfwa;-� t4'
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PropertyTax ID #: Lot No. —
Site Plan Name: UiffSMIZ. Block No.
Project Name: Wfil 9 "09OYRA I
Setbacks Front Back: — Right Side: Left Side:
'e
DETAILED DESCRIPTION OF�WORK;�
TO Oula 9 5�IXO DUO MOW* 609 W064 5Pfi16 Abfi
CONSTRUCTIO.4 INFORMATION.-
Aciditional worKtO 13 erformed under this permit — checK all apply:
EIHVAC Gas Tank E]Gas Piping M Shutters F—]Windows/Doors
11 Electric Plumbing []Sprinklers E]Generator 0 Roof = Roof pitch
Total Sq. Ft of Construction:
Cost of Construction:$ /00
So- Ft. of First Floor:
Utilities:1] Sewer 0 Septic Building Height:
OWNER/LESSEE:
CONTRACTOR -
Name WKFASAdc pf,
Name: PAW fibilf-
Address: W Vi79 I C2
wglfi In
Company:
City: �Ar5r�1_6112 State:
Zip Code: Fax:
Phone No.
Address: J'W1
� .
City: A& - - State:4�_
Zip Code: 7111747 Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail4a4ve mr
State or County License:
it value of construction is 5Z500 or more, a RECORDED Notice of Commencement is required.
S PPLEMENTAL"CO N�T
0 9STR l'ON WIEN LAW INFORMATION:
7 "____2'Not�pplicable
DESIGN ER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY:
Name:
Address:
40n
Address:
City: State: _t�
zip: Phone: 77;? 1 0- 77,U
city: State:
Zip: _ Phone:
FEE SIMPLE TITLE HOLDER: _.L/Not Applicable
Name:
BONDING COMPANY: ZNot Applicable
Name:
Address:
Address: 1Q7A
City:
City- P I
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 ma estrict or prohibit such
ic
structure. Please consult with your Home Owners Association and review your deed for any restrictions ynii h may apply.
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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
commencing work or recording vour Notice of Commencement -
Signature 009ner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA L—L, '-e STATE OF FLORIDA
COUNTY OF CA — �COUNTYOF
The f ing instrurpgRit was acknowledged before me
this May of L )f"Ny 261(�,_by
(Name of perso_nIck6owledging
a±:�rr\ !A —
(Signature o(Jotary Public- State of Florida)
Personally
Type of ld�
Commission
Revised 07/15/2014
rualic State Of Florida
")730
May 27, 20;3
The f Mrgoing instrument was pcknowledged be ore me
I -%^ V
this y of J�A , 20 LG by
karrw ua�>
(Name of person a+nowledging)
(Signature of Not ip Public- State of Florida ) I
Notary Public - state Of Plorlda
— COMMISSIOn # FF 234730
MYUOMM. Expires May 27, 20 1-,
Bonded throtigh Nafmn,' 4 ...... f,
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