HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APP8W TO BE ACCEPTED
Date: BY Permit Number:— 01 (p
St. LuCie County
RECEIVED
Building -Permit Application
SEP I - 2017
Planning and Development Services
Building and Code Regulation Division
-23 . iniaAvunue, Fort Xerce-Ft-34982------
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: -D c) c>Q--5 4 U,3 �v) Z� 6 ff-rr-J��-7
Address:
Legal Des
PropertyTaxID#: 4 s \ I S; V4 L� C��R'k— c>cD b —k Lot No.
I
Site Plan Name:
Project Name: ��6e> p(C SkZ (-c� .6414 1 If 11� N V
Setbacks Front Back: _ Right Side: Left Side:
t- ,z4C-C- -2 a"-T-j2� Voo��, Arin -2, � E,� , Csr P iN��s
Block No. -
-Mechanical GasTank Gas Piping Shutters Windows/Doors
Electric Plumbing Sprinklers Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities' _Sewer _Septic
Name A (- t A,�
Address: 16 '4 10 75 ' a r L� M
city�-U-15, 1-1. g!�az, C-it7� State:EL-
Zip Code: 73 \A 1� 1,�:� Fax:
Phone No..-I'2�L+ \-nt.-, -kS'2�3
E-Mail: 1L� L-Lv4l J�J n00,V c-Q-A1Xt10 i�- i uu
Fill in fee simple Title Holdbr on next page (if different
from the Owner listed above)
Roof
Building Height:
Pitch
Name: �Lic-VTVL�L- F-05&0�rC5
Company: "�� t�c, ff� z.-
Address: ��3<"
city:zS�-Nsa--i —State:qL-
Zip Code: 3��3-7 Fax:
PhoneNo-79;; -1-7Z-32,ct�-2-q'ib
E-Mail
State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMIENTAL CONSTRUCTION
LAW INFORMATION:
Name:
City: st-r W'�� !)tate:
Tip: 34m '3-Rci-i Phone:
FEE SIMPLE TITLE HOLDER' Not
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
X Not Applicable
Name:
Address:
City:
State:
Zip: Phone:
BONDING COMPANY:
—NotApplicable
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit -
I
St Lucie County makes no representation that is 9
which is in conflict with any applicable Home Own
structure. Please consult vAth your Home Owners
.e the permit holder to build the subject structure
or and covenants that may restrict or prohibit such
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 revieur- room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residentiai use
WARNING TO OWNER: Your failureto Record a Notice of Commencement may result in your paying tuAce for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the firKinsp-ection. If you intend to obtain financing, consult with lender or an attorney before
Agent
STATE OF FL
COUNTY OF
The 10 ing instrume was acknowledged before me
this / Fday of 20 Ljby
STATE OF FLORIDA
COUNTYOF M&t-hO
The forgoing instrument was acknowledged before me
thistO dayof ::51tly 20 L2 by
filleen prjce�
(Name of person acknowledging .(Name of person acknowledging)
(Signature of Notary Public- State ofFlorida
Person yj"owp,
Type of
CommiL
Revised 07/15/2014
REVIEWS I FRONT I ZONING
COUNTER REVIEW
TSignature of Notary Public- State of Florida
P ona 'y
T;�e of I'd e
Commissio=
SUPERVISOR I PLANS VEGETA-PON SEATURTLE I MANGROVE
REVIEW I REVIEW I REVIEW I REVIEW REVIEW
R T1 10 M