HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION.TO BE ACCEPTED
Date: SCANNED Permit Number: 0
BY
St. Lucie Countv RECENE®
Building Permit Application APR 0�( 2vt/
Planning and Development Services .
Building and Code Regulation Division
23oo Virginia Avenue, Foit Pierce FL 34982 - ,te County, rL
Phone: (772) 462-1553 Fax: (772) 462-1S78 Commercial Residential
PERMIT APPLICATION FOR: To'select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 180 N OY i�1 1CI Yl U C {� i �h W Du A— n'
Legal Description I?-?�r'i 'ActSW ��H'\f.% QniLiigp As J- N�> 18SC�.1 ,qS �W .4
Poe yTaxlD#i-�tln'"n": 2312 2 1-.08�3-1'�A6'S. Lot No:
Site Plan Name: Block No.
Project N ame:T I I Ff.IQ�Yf/;
Setbacks Front . Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
�l1 OwfV-y SlAf f Iied akA S '4141V1 4,8 &
OIcI Zxis{ir�aY �-f1A s 2,4,u,�,8 � NjAu -
NO-ilCAR - A, EWC)V•U
CONSTRUCTION INFORMATION: III
Lj Gas Tank UGas Piping
0 Plumbing Sprinklers.
Shutters Q Windows/Doors
Generator ElRoof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floori
Cost of Construction: $ 43 �$ s . eA Utilities: Sewer El Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name CF i UC
Name: _tOWR
,
Addres4o
PDX StAq-46
Company: C.Grnalo- Cnam
m rha.vl,•ea !Cf
City: 06 state--K�
Zip Code: ' Fax Rus- 2q-1 - A-;,3
Phone No. _'1:1lfkDI' 8eq I
Address:llags NW 41N
S[•
City: 0Crx1 6l..
Zip Code: 3LA11:K
Phone No.
State:ice
Fax:3i2-3S"I-92IQ1
E-Mail: kip. Glil °n f 'i lDt7r^W_l W-kY-C- CklM-
Fill in fee simple Title Holder on next page (if different
from the Owner listed above) •
E-Mail: T)IU SS . -f—VA
ate r County License: 0MC.6S(9
q 2T_
If value of construction is $2500 or more, a RECORDED Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: of Applicable
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
commencing work or recordine vour Notice of Commencement_
as
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before rrie
this _ day of m 20 _by
1
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. (Seal)
Revised 07/15/2014
The forgoing instrument was acknowledged before me
this_q 01day of KA61YCh 20 1r) by
UuL2 wtSe- -1L
(Name of person acknowledging)
(Signature of Notary
`Public- State of Florida )
Personally Known " OR Produced Identification
Type of Identification Produced
Commission No.
Florida
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
_
INITIALS
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