HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ` O
Date: 1 • ID I rl SCABN1NED Permit Number:
St. Lucie County RECEIVED
Building Permit Application JAN 10 2017
Planning and Development Services
Building and Code Regulation Division PERMITTING
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 III
Address:
Legal Description: St1-bdi Vt si m I+a b_Tco(o a5-3q5 - 40t
PropertyTax ID #:5 lQ O DOD00000 Lot No.
Site Plan Name: 1,6L . QV) The. Oo-Ca-n Block No.
Project Name: 50i r) QL S O n ' -h e C) OLO-4-L
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF,WORK V` a
Ins`L-c A ao' �c IV Vhigh We, MCe .WCltLstll_lre aa1DA_L_1r1 a9+ertem
I,J r�Wi l a,cll w.�bt e 9 a�-e,
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CONSTRUCTION INFORtV1ATION:i;3
AdClitiona wor to e ertormea un ert ispermit-c ec K 14
a apply:
HVAC lul Gas Tank Gas Piping _ Shutters E]Windows/Doors
ElectricPlumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sr. Ft. of First Floor:
Cost of Construction: $ '"RQ5D Utilities: L. Sewer Septic Building Height:
OWIUEft/UE $EE f, `'
a _
COTRACTOR
_C
Name 5aY'NGLS On'rhe Deeo-n
Name: C1''1e,54-f M6-!N0�'
Address: 9100 M P4 I ft
Company:t ZIGX+ I hEXnC� COM jJ A.N U
_
City: { -f- fteJ'� r State
Zip Code: 34-9 A' 9 Fax: I
Phone No. i1'ci' �i-(o(n -q 7T
llS
Address: i'b 8C),L(09C,
City: 5�"k State: FLr
Zip Code: 54,TQ5 Fax:T79-5IM-3035
Phone No. 117 a - oL7 , l I I
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail•'4�J Ce_a ✓ .9au4il . n P_f
State or County License: o;1_0 R ` g
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMF, ALCONSTRUCTION11EIVLAWINFORMATIC!N:'
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name: _
Address:
City:_
Zip:
I certify that no work or installation has commenced prior to the issuance of a permit
Phone:
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contlict 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
commencing work or recording vour Notice of Commencement.
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF W a_y-4-t"t I COUNTY OFMaal-1 n
The forgoing instrument was acknowledged before me The for oing instrument was
acknowledged before me
this day of 20 Eby this,day of tt xu 20 '� by
C-4l_. 7S c (U "1'1 f'VLEiM O� 0. Le4"— :g Le-h N044- L/
(Name of person acknowledging) (Name of person acknowledging )
� � • `� Il �LJB-i1.G�-
(Signature of Notary Public -State of Florida) (Signature of Notary Public -State. of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. 15FANJE K BOND
MYCOMMISSION#FF185
Revised 07/
Personally Known OR Produced Identification
Type of Identification Produced
No.
E K BOND
EXPIRES December 28, 2018
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