HomeMy WebLinkAboutBUILDING PERMIT APPLICATION.,S
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ZD )-1 Permit Number:—
oulANNtU H ® UEd'a- ED
BY
Lz
'� �3t. Lucie Countv JAN 19 2016
Building Permit Application
Public Works
Planning and Development Services St. Lucie county, FL
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ✓ Residential
PERMIT APPLICATION FOR: Sign
PROPOSED IMPROVEMENT ..LOCATION:'°
+-
' YD
Address:
Legal Des
Property Tax ID #:
Site Plan Name: -
Project Name::Y\SCeX VP IrJOT
Setbacks Front NIA Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORKi
'?UO
CONSTRUCTION INFORMATION: ,
Lot No.
Block No.
Aclaitionai worK iO De errormea under ims permli— CneCK all joill apply:
[--IHVA( 11 Gas Tank E]GasPiping _Shutters ❑Windows/Doors
11 Electric El Plumbing Sprinklers 11 Generator 11 Roof Roof pitch
Total Sq. Ft of Construction: CZ15- S_ S Ft. of First Floor: 0 S
Cost of Construction: $ b 0 o� Utilities:12Sewer Septic Building Height: It'
OWNER/LESSEE: =
CONTRACTOR:
Name Z r h
Name: f" r
Address: c2ssn
Company: T r IS iex-
City: State:El_
Zip Code: 4LP Fax:
Phone No.
Address:
City: vLAn StateT—L_
Zip CoderL 0w/I/1
— Fax: I I�-S19 -93(3
Phone N — -
E-Mail:
Fill in fee simple Title Holder on next page I if different
from the Owner listed above)
E-Mail:
State or County License: C
If value of construction is $2500 or more, a RECORDED Notice of Commencement Is required.
as
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY, _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ -Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
City:
City:
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 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
commencin work or recordingour Notice of Commencement.
s
Signature o Owner es ontractor as Agent for Owner
53g'nature of Cant for/License Holder
STATE OF FLO IDA,j j�'
COUNTY OF �Vl (/L�A IfL I �{rL_
STATE OF FLORIDA
COUNTY OF I na >n `Cah
The f rgoing instr ment was acknowledged before me
thisl�lfay ofc��nu� !%by
The for oin9 instrument was acknowledged before me
thils 20 I by '
of=0n(l)6A
/20
L r A-e'
A�day
kA-q& 11
(Name of person acknowled ' )
(Name of person acknowle ing
(Signature of Notary P b - State of Florida)
(Signature of Nota ubl tate of Florida)
Personally Known OR Produced Identification
Type of Identification Produced
Personally Known OR Produced Identification
Type of Identification Produced
,,,111;",� MIST LUNDEEN
Commission No. •o"" °��.; Not4pl�lic - fihd of Florida
=. CemmlfelOn N FF 956571
r 25, 2020
Commission No. ��,,,, TY LUNDEEN
?4:s Notary Public - Slate of Florida
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! '�%°f,;;.•``� SondadlhroughNational NolaryA5an.
Revised 07/15/2014 _ - -1t
%9, My Comm.EzplreaApT 5.2020
Bonded through National NotuyAssn.
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS