HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED )� O I I
Date: f �' l �) Permit Number:
_._ w SCANNED
Building Permit Application BY
Planning and Development Services St. Lucie County
Building and Code Regulation Division
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
PROPOSED IMP
,.-
EMENT LOCATION:
_
Address:
129 P_Y1111 1 Q1-_
F= _ dot �✓t2
/� 3y
Legal Description:
Lei 1C L i,V coot Gr"L— LN i
1� 1'Ou
o r 1�fL��Y ��v1C� t e et cl
lL�
h',IIi5
L ;nlb�
:I/ F}C-i3L
��� sue) as
Property Tax ID #:
-� r ` �
—
`��/�i'
��--- . �
Site Plan Name:
Project Name:
Ct, iN 0 D 7 �� f(,
Q, Yt LC:O 017� 2ll0
Cf r VW✓/P✓
`J SS ,
Setbacks Front
Back: Right Side:
Left Side:
DETAILED DESCRIPTION OF WORK:
N �T/� �i,�-> I �►� a F L-}ce_ rr, Cra"e S t t y 1
�W� C27 D��n�,1,� w�rE✓I� �ectr Cexan I a�1�)S c,1��I .� .
mv
ONS RUCTION INFORMATION:
Muwuuuei wu1n w uc cnunncu unuei uua Nen uu—uie�n au aNN�y.
0HVAC Gas Tank E]GasPiping Shutters ❑Windows/Doors
11 Electric 0 Plumbing []Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: ScFt. of First Floor:
Cost of Construction: $ S 1 a Z ° 8D Utilities: Sewer D Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ILFt3JcE c -i"J i�
D net -IS .S •
•Name: %C1CK
Address:-7,50-ZVl)1 i t
Company: ��T • (ate-�'r� CD�✓� S'�s���'-7'�
City: F4 - 1 era State: _E— L
Zip Code: 3 q C J I Fax: 77 Z-6W- y 3
Phone No. -7_77-- 40— g3ti7
Address: 1'D
City: EJ✓-"� t F I-CJL State:_P_�
Zip Code: �J4 �> 1 Fax: -T7-2--79q-�� t
Phone No. D-77=
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: C' vte S �Lu F i'7CG
State or County License: �4 q `� ITAI
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 TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not 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 recording our Notice of Commencement.
P/1 f r1,LYf,Y)/a�.� - 1 s
ac,. �
Signatur of Owner/Lessee/Contractor as Agent for Owner Si at i e of C ntractor/License Holder
STATE OF FLORIDA t / f n , ORIDA
COUNTY OF � n L—, COUNTYOF
The f oing ins
this day of
person
ANGELA M HUFF
8 FF
Revised 07/15/2014
27, 2019
me The forgoing instr ment s acknowledge before me
this day of 20 (4by
(Name of person acknowledging
of Florida )
OR Produced Identification
ANGELA M HUFF Y
Gommiss�tof Florida
FF 2341.11
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS