HomeMy WebLinkAboutBUILDING PERMIT APPLICATION4 `
pll APPLICABLE INFO MUST BE COMPLEt t1i'rOR APPLICATION TO BE ACCEPTED L
Date: �J,� Permit Number: �.1013 —d lz'SS
RECEIVED MAY a' 1017 SCANNED
BY
St. Lucie Countv
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 �I
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial rk Residential
PERMIT APPLICATION FOR:PJ� V, .
,RQ.P.®SED/tNP.R�DUE'M -NT LOGAJTI®N:
Address: ! 0 /®I a2t1t,, Ay. /;C:�'r c'.. r
Legal Description:
property Tax ID #: 9 -3 / Z �� Zy�0 / Lot No.
Site Plan Name: 6&ady -ear Block No.
Project Name: Cnns— un l
Setbacks Front / 20 Back: 4M. Right Side: oa- 0 Left Side: 3l�
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof I Pitch
Total Sq. Ft of Construction: '/0 Q' S'F•� 7 Sq. Ft. of First.Floor:
Cost of Construction: $ Utilities: —Sewer —Septic
Building Height:
OWNEti�JLESS.EE:
CON RACTO
;Name �/'� So,C'..'C3�i . i0(OLtrd 1
Name:; :m:�LGe)IL
"ir' , -
dtldtess: G t, P ` Rom
-company:` —
c:
-City:"'- 7. D�: :--'---' Sate:
Zip Code: ?L/rtY7 Fax: G 7 f 33
Phone No. i
33/ 5%Afe7e 'I)l'
-Address:
City: '�/r . a State:_
Zip Code: Y 1�� Fax: e� 7
Phone No a0/ 937-(2
E-Mail: SL{-rireS(* Cto °.Coky\ ..
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail %ttJ� ��l 33/ Ua1d. ,
State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
Lo
Name:
Address:
City: State:
Zip: " Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
i
W
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Address:
0-3
_Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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
structure. Pleaich is in se consult ct with w thpyoiurHle Home Owners ome Owners Associationtion andrreview your deed for any restrict that
which may applyhlbit such
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 Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF S'I-- L'uUe-,
STATE OF FLORIDA
COUNTY OF SI L%C-s2-.
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this _11 day of IA&�( 20L7/by
this '; day of T 20/-Zy
c
(Name of person acknowledging)
(Name of person acknowledging )
►KaLn un� ��la cQ1.>�_
l iO✓ ILAu=�,�+-r `�1n-a_A_Jel-may '
(Signature of Wotary Public- State of Florid
(Signature 8f Notary Pu61ic-State of Flortda )
Personally Know OR Pr
Personally Known OR Produced Identification
Type of Identification Y KARYN G DRA�YDY
Type of Identification
Produced ••- OMMISSIONNFFI9
Produced YNGDRAWDY
Commission NO.GI-iq ° EXPIRES February it, so19
',� (S Nola xmm.w•
'•?My= _.IONWFF1n
Commission No.� v0
/S
eeluary 11,:
14M 39HIS3 nmdaaNw Bmirq,¢yi.
REVIEWS
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DATE
RECEIVED
'01-17
DATE
d
COMPLETED
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ev.