HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: an Permit Number:
L�VMKIMTW _ -1 RECEI'."?D JU)) 12 2017
Building Permit Application 6GANNE®
Planning and Development services St. LUce r`
Building and Code Regulation Division nnnti ,
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 III
Address:
Legal Description:Qerym_5 mSLxIWD I,Ulrak R140FTMeAT-1. L-f& a o1F
�ACC�S R15MVIL- 949 arJ,DI& SoFP1PdZ t.ea%> * n., a89 aa2 tag QOA&C212 94 l4kMLec
Property Tax ID #: ` 6W -- (56) - IIAS-000 - ofqqLot No.
Site Plan Name: 1 — Block No.
Project Name: Iyi�CfLlrS J �l}1�11J %LU131101CS
Setbacks Front Back: Right Side: Left Side:
IL � tJC1 CJG UPJL,-f : F-UMUU— CKAL^ -to aee k M-tXA4. I TU wu , % "zrrcec %
LRdWtat3\-en-E -i n54ml,I rxeti meC-eSSar� ctie.-1al5i dnd+ ir%5ia1.1 r\eu> Skz'"01•eS -
Alt,Q-51NIA t,, Fta#rcOFS- arm .lo r+e6le0e a- GQco S;Uc&ne_ ror,F stssAm-
11HVAC U Gas Tank ❑Gas Piping U Shutters Windows/Doors
Electric Plumbing Sprinklers 11 Generator Roof Fl5i'j Roof pitch
Total Sq. Ft of Construction: 5ct-o S Ft. of First Floor:
Cost of Construction: $ 35 t56D. 6 a Utilities.. —Sewer Eheptic Building Height:
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Address: QR04 5. QC -CZ
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City: 'Jtyf Yl 'Reach
--Zip Code: 1- FaxJa2-�-
Phone No.�- Ina - �
State:
8033
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City: 5+U0f_+,
Zip Code: LRc(i'
Phone No. - 34oi -
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Fill in fee simple Title Holder on next
from the Owner listed above)
page ( if different
State or County License: L' '�.
it vaiue or conscrucaon is>ebuu or more, a KecoKDED Notice of Commencement is required.
Name:
Address:
City:
Zip: Phone:
Not Applicable I MORTGAGE COMPANY:
State:
_ Not Applicable
Name:
Address:
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
commencine workle0ecordine vour Notice of-00hmencement.
STATE OF FL
COUNTY OF
The forgoing instrument was acknowledged before me
thijDDday�ofG� _ 20 by
/ 1Q,,x jUte
Persdnally Known
Type of Identificatio
Commission No.
Revised 07/15/2014
1, 2021
STATE OF FLOE DA /_
COUNTY OF
The forgoing irs9trTment was acknowledged before me
this 6'jt�dayof t. it 20 by
(Name of per�'dn acknowled ing
(Signaturk of Q_9eary Public- State of Florid
Personally` Known ti ProduLdditPdlMI ation
Type of ldentificati it d Notary Public -Rate of Florida
tbamnssimi883090066
C M.Evpir�es May 1, 2021
Commission No.�• �� mraeh Y ,ansm
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