HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED e -
Date: 6GANNED Permit Number: I O lCl�
BY
St. Lucie CountyEVED
w s
Building Permit Application FEB 2 8 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 X Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
Address: 107,00 S 0rl741!! /J2 ZbZ
Legal Description:
r—MLIE
Property Tax ID #: q5 /l — S /Q ^Oct/U— QED — t/ Lot No.
Site Plan Name: F/nJIV92FA *W Block No.
Project Name:
Setbacks Fr
Back: T Right Side: N p- Left Side: N
I.YDETAILED DESCRIPTION OF rWORK s _'; `
W INo0W.;_ t� /R It•� T y oP&N IJG5 —2 w r evw 5
�'MP�1 CT �'0_ 5L401n I, 1'3 J✓L
OHVAC LJ Gas Tank
❑Electric OPlumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 1 Z 13So
Piping I (Shutters
nklers ❑ Generator
S Ft. of First Floor: _
Utilities:n Sewer ❑ Septic
Windows/Doors
❑ Roof ❑ Roof pitch
Building Height:
bWNRJLESSEE
.
CONTRACTOR
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Name Fn A/
Name: MrcifAB 6t;v0AV/NFL
Address: /O$8Yo IGnmt.�_I kF po >2
Company:-1(N. 4 A.FT) r2 LUMllyasA
City: 5v2e�f5 Stater
Zip Code: ggoq I Fax:
Phone No.r2t-A — O95'I —63?i b
Address: Nui FEOT: MAt_ qwy
City: A'VL-t—
Zip Code: S499N Fax: 0-4
Phone No. VZ--692-00Q0
State:'F7�
-9—g!J
E-Mail: 'F/NN /v&7
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: MI Gid"A ELI_Crr)&,t(//J0
y A—Co.CDN^
State or County License: C�l SO��-
If value of construction is S2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable
Name: 5UNCO!KY AbioulwaAA
Address: 13101a S5,ru 4h2egritsa" smorle
City: C L— State: F
Zip: �7� o Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
City:
Zip: Phone:
State:
BONDING COMPANY:
Name:
_Not Applicable
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Count
yy 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, 1 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 addit
accessory structures, swimming pools, fences, w Is, signs, screen rooms and accessory uses to another non idential use
WARNING TO OWNER: Your f 'jVregorflCa Notice of Commencem suit in yo aying twice foimprovements o r rop yoommencement mus a re d on the jobsite
before the fir ins a 'on. yoo obtain financin er orn� before
comme el dice of Com ceme
s
Signature of 0 ter/Lessee/Contr r as Agent for Owner ignatu e o ontractor/Lic nse Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF ST�/xi.5;7
The forgoi instrument was acknowledged before me The forgoing instrument was acknowledged before me
this of '!�r 20/Zby the Ay of , 20/1" by
(Name of person acknowledging) (Name of person acknowledging)
(Signatur -Notary Public- State o�rorida) (Signatur otary Public-StatteeriMorida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
MY COMMISSION 0 FF 173907
Revised 07/15/2014
Personally Known r/ OR Produced Identification
Type of Identification Produced
Commission No.
: December 7, 2018
Nntary Public Underwriters
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