HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I' 1 j\ n Permit Number- I a
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BY
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St. Lucie County V
Building Permit Application NOV 14 20%
Planning and Development Services PERFAITTING
Building and Code Regulation Division St. Lucie County, FL
23DO 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 III
Address: 7757412 S o, /-// U S/
Legal Description: 2 2 3 6 V o 5- 2L--�n £y- ,3 Se.-iLle , 22 t y/us e'o'e osil
Property Tax ID #: 7? V .9 Z - rf y�/— OOO 2 — O OD 3 Lot No.
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CoU-0V $ree2w-1 0.wd
Co
Block No.
CONSTRUCTION INFORMATION:
itiona wor to e e orme under this permit checK all Mat apply:
�HW Gas Tank E]GasPiping Shutters ❑Windows/Doors
_
Electric OPlumbing Sprinklers Generator Roof = Roof pitch
Total Sq. Ft of Construction: 2 3 3 S Ft. of First Floor:
Cost of Construction: $ `'2 2 5-0 utilitiesSewer leptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name MCSC- A/cldiH.<
Name: ki S(AJI
Address: V061 i7., (facrra,cc4 'Dr
Company: swiezv ['nhc�ruc7/Oy
�o
City: 1%/ Pi e; c o State: 1=L
Zip Code: Fax:
Phone No. '7 72 2 Y d D 93 S-
Address: 9 2�/7`o h
12,1
City: /)or i Si. L ✓, i,,
Zip Code: 3 V 9 S.1 Fax:
Phone No. 7% -:2— 3 5 9—
State:—/---C-
E-Mail: D R M G a o/, c o w\
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: S,/4e4,')L4e vra n 39 6
ma i i , co
State or County License:
If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: 0_ Not Applicable
Name: Pao ( W.0 ( C.lk 1,kc Name:
Address: 14 S V .S W R. // moo, e xt-11Y Address:
City: 110 r+ + L v tl c State: FL- City: State:
Zip: 1 8' F Phone: 772- 795-9�'f�fi' 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 inspegion. If you intend to obtain financing, consult with lendAr gr an attorney before
as
STATE OF FLORIDA �� STATE OF FLORIDA
COUNTY OF��'J- zaenc COUNTY OF
The forgotng instrum t was acknowledged before me
this jdayof K 0V. 201&by
Personally Known _
Type of Identification
Commission
Revised 07/15/2014
of Florida I
The for oing instrument was acknowledged before me
this,dayof OV• 20 _jyoby
(Name of person
of Florida)
OR Prod d Identification ✓ tPersonally Known OR ProduS90. tification
iced r).Z Type of Identification Produced Y(..O. l-
�N S. NIEL5try
:ommission N FF 115637
My Commission Expires
KARENT-."NIELSEN
Commission q FF 115637
June 12, 2018
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