HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �{
Date- S-zb`SCANNED Permit Number: I ' I0�—O
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St.'Lucie Count, f-
Building Permit Application MAR 3 0 2017
Planning and Development services'
Building and Code Regulation Division PERT iITTINGSt. Lucie Qounty, FL
2300 Virginia Avenue, Fort Pierce FL 34982 -'
Phone:-(772) 462-1553 Fax: (772) 462-1578 Commercial ✓ Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow:at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 'f ri Y% /i�GrarO,�tJ
�
Legal Description:" ,�n /CZi,f 'COsi Si�,Q A4 a
A n ,i,I .. - n n .nn
PropertyTax:ID#:g_y/-6 - 0 . .. r Lot No.
Site Plan Name: " - Block No.
Project Name:
l/LY N� �� _now-P Chu v�.ut a�rLa
Setbacks Front-/7 Back: RightSide: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTIONINFORMATION:
Arlilitinna wnnrrkM no nprtnrma�rthic norm its
II ❑HVAC ❑ Gas Tank ...
i
Electric O Plumbing''
/ye9-6Q)7
Piping LJShutters
nklers ❑'Generator
❑_Windows/Doors -
El. Roof " ❑ . Roof
Total Sq. Ft of Construction: 2 a , S '.:Ft. of First Floor:
Cost of Construction: $ D. a , 0 e) Utilities: Sewer ❑Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name d.6Q a, r e
Name:. ,
Address:_ '% D '7 A.�to�.rU ai,L-
compan If
City. cr: States'
Zip Code:. & Fax -
Phone No. -77-'� 96 9la
Address: J ►
0ccca�a�y gQ -
City: , P 4 &-e2
Zip Code:'3
Phone'No. 77
State: Qi
Fax: 'yG y` rid
L.9
E-Mail:
Fill in fee simple Title Holder on next page( if different
from the Owner listed above)
.
E-Mail:S7 &A S 30
State or County License:' 4-3-
4 %O®D O ISr J
r
n vaiue,or construction: is p4wu or,more, a ntwnuru Notice of commencement is required..
Nam
Addl
City:
Zip. :
ON LIEN LAW
— o.�:: -, - --- -
FEE SIMPLE TITLE HOLDER:::.. Not Applicable
Name -
Address:
City:
Zip:: - Phone:
MORTGAGE COMPANY: Not Applicable.
Name: ..
Address: -
_ . City: - State: -
Zip::..... _...Phone:...'
BONDING COMPANY-., _Not Applicable
Name:
Address
Zip: Phone:
I certify that no work or installation has commenced_ prior to the -issuance of a permit
.:St. Luc' e{ount makes no representation that is granting:a permitWillauthorizethepermit Holder to.build the subject structure:
which is in contIlct 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 Twill, 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 your Notice of. Commencement.
STATE OF_ FLORIDA c'
COUNTY OF.
The forgoing instrument was acknowledgedbefore me
this r day of 20 (2by
Personal r;pf' ation
Type of I2--ij?
n=,9%9 -
Trade L Lamb
Commiss,' r MYcaemloea7e�eal)
Revised 07/15/2014
s ..
Signature of ntractor/License Holder
STATE OF LORIDA
{OUNTY F
The for goinginstrument was acknowledged before me
thisLday of1 \_ 20 Eby
(Name of �son acknowledging ). -
(Signature of Notary Public -State of Florida )
Personally Known- OR Produced.ldentification
Type of Identificati
Commission No. Q� icleLL
mYcommiasb mbcM {
7ea3 '!o{S�
.,,. Expiresotnsno2o
REVIEWS
FRONT .
ZONING
SUPERVISOR.
PLANS..
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS ..