HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED permit Number: IEIJ ' �1L0
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Building Permit Application MAY 0 0 Zii,r
Planning and Development Services
Building and Code Regulation Division PERATTING
2300 Virginia Avenue, Fort Pierce FL 34982 - SL Luoie County, FL
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:
5./J.I-
Property Tax ID #: 7 Y/Y- 50/- / yU - J` O y Lot No.
Site Plan Name: P«Zt Block No.
Project Name: %1?C�t5G/,e?6'f CO A57- /YeA,!5Z4 64a13.
Setbacks Front Back: Right Side: LeftSide:-
J-DETAILED DESCRIPTION OF WORK m
%I'�puicc �K/577NCj TD/LGT /,1J /1ZY1 LJ/�//�L1fYNT �fjjj7QQ/YJGtI�liOfi i.�V/401
> A)D Marc- G-(601 G u � i�-0� /e �t q� a,
,� M IINU R RYwIL MGM Z'
CONSTRUCTION INFORMATION: - -
LIHVAC L,(Gas Tank Gas Piping
11 Electric % Plumbing Sprint
Total Sq. Ft of Construction: �/ 2500
Cost of Construction: $ 2yOd e
Shutters Windows/Doors
Generator a Roof Roof pitch
S Ft. of First Floor:_
Utilities: Sewer❑ Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR: -'
Name AL LA Pdf 7-E
Name:
Address: gapt) /'L Lau I-F
Company: TELFS6 �iU/L�£�S
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City: Pd_ /L�STL`/i/r State: 'L
Zip Code: SY Fax:
Phone No. 77Z - ✓3 SO a 0 3 /
Address: SD/DD .5M
AJ7V_IF% 1A_A,0
City: A02! -S kual6
Zip Code:
Phone No. 772 u/�P�D-�/�9D
State: -
Fax:77a
E-Mail: !!� cGWI
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: Oat*IIefle R) /'L'//sDLI
M • 11dr
State or County License: 1-16
C
it vaiue of construction is $2500 or more, a RECORDED Notice of Commencement is required.
I`SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: III
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:�tlU�ih "7W7u/� *>aC/YeW1 Name:
Address: Address:
City: State: City: State:
Zip: Phone• 3 — Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable I BONDING COMPANY: _Not Applicable
Name: _
Address:
City:
Zip:
Name: _
Address:
City:
Zip: Phone:
1 certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Counttyy makes no representation that is granting a permitwill authorize the permit holder to build the subject structure
which is in conflictwith 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 recording vour Notice of Cnmmenremant
Signature Contractor/License Holder
STATE OF FLORIDA� t STATE OF FLORIDA
COUNTY OF -+/, /Pi COUNTY OF , kk A k,r.t
The forgoing instrume twos acknowledged efore me
this dayof� 20/_by
Personally Known ifi�ha
Type of Identification Pr u{8
Commission No.
Revised 07/15/2014
(INIPission# GG 5M8
My comm. expires Dec. 22, 2020
The forgoing instrument was acknowledged before me
this 4". day ofnrl"t 20)__+ by
(Name of person owledging )
Personally kkowh.OR
Tvoe of Identific ion Produces
PubOo, State of
18,
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