HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONk�
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SGANNED Permit Number: (00 (,0
BY RECEIVED
St. Lucie countv
Building Permit Application JAN - 4 2017
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34992
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial \Z Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
— _1_, — � D-=5
Legal Description:- \<)�Vff ki 65--
Lot No.-
PropertVTaxlD#:
Site Plan Name: Block No.
Setbacks Front Back: Right Side: Left Side:
DETAILED, DESCRIPTION OFWORK;
Tcxs\
_C6N sTRUCTION,IN FORMATION:
'�-fiderthii.-P-er-M-rt---Che-CVa7FI
AQ(31110nal WUIN LU
11
app y:
DWinclows/Doors
GasTank
—Shutters
Roof pitch
ID
FQ
L—BElectric EjPlumblng oSprinklers
Gene rator Roof
Total Sq. Ft of Construction: S Ft of First Floor:
1:1 Height!
1 C5 C�,o Utilities: — sewer Septic
Cost of Construction: $ k\ — Building
OWNER/LESSEE:
CONTR�.CTOI�-_:',:�,_-_�
Nam
Name: 75o�n JY-C
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Company:. a)y -\rVe I
Address: 12>LkSZT-11�1(7
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Address: ye!
City: -42c�- State: ±ll
Zip Code: ,;Q qi=� -2- Fax:
Itk-
city:�� -
zip Code: ';L-%c32,_3a Fax: �:Apsi_z_
Phone No.
E Mail. N
Phone No__11�� - 9 q9 -960 _IDLC3�
E-Mail:
Fill in fee simple Title Holder on next page I if different
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from the owner listed above)
State or County License:
if value of construction is $250D or more, a RECORDED motice of Commencement is required.
NSTROC-,Ti6N-L 'ILAW INF RM. ioN 'C �,c;
PPLEWLINIT-AL't IEN
DESIG , NER/ENG - INEER Not Applicable MORTGAGE COMPANY: Not 1�p�iicable
Name: Name:
Address:
Address-
State: City: state:
City: zip: _ Phone:
Zip; Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: —NotApplicable
Name:
Name:
Address:
City -
Address:
City:
zip: _ Phone:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a.permit.
StAucieCoun makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
Mict Homeowners Association rules, bylaws or ans covenants that may restrict or prohibit such
which is in co with any applicable
Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
structure.
of the . granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
In consideration
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,
fences, walls, signs, screen rooms and accessory uses to another non-residential use
accessory structures, swimming pools,
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
Commencement must be recorded and posted on the jobsite
improvements to your property. A Notice of
before the first inspec�ion. if you intend to obtain financing, consult with lender or an attorney before
commencing work or cording your Notice of Commencement.
S
SignAture of Owner/Les�be/Oontractor as Agent for Owner Signatur of ntractor/Uicense older ---------
STATE OF FLORIDA STATE OF FLORIDA
01 LLII� 1��_
COUNTY OF—G-r COUNTY
The forgo. 9 instr ent was a knowledged before me The forg Ing inst ument was acknowledged before me
this day of 20 by
this .�?O,Zay of 20 q1by
Ak
Nam of person ackno e Ing) (Name of person acknowledging
(Signature of Notary Pu I - State of Florida I Signature of Notary Public- e of Florida
ed dentin
Perso 11 Kno n 111 0 n1flion Personally Known OR P!fuc,
MANI am-- Type of Identification Produc C
Type I enti I
COMMISSION I FF190294 (SeQ
Commission No;
Com iss on oA PyDing 15,2019
Brenda J. Williams
WWWAARONNOTARY�Com "Aw"Pal.
aQ COMMISSION # HlUUZ94
EXPIRES: January 15, 2019
Revised 07/1512014
Willi
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGErATiON SEATURTLE MANGROVE
REVIEW REVIEW REVIEW
COUNTER REVIEW REVIEW REVIEW
_'ffA_TE
COMPLETE
INITIALS