HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l p
Date: SCANNED Permit Number: ' I - • s o
BY
St. Lucie County RECEIVED
Building Permit Application
Planning and Development Services OCT 12 2017
Building and Code Regulation Division P-R, ; %
2300 Virginia Avenue, Fort Pierce FL 34982 Si LEI ie . -,
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residenti 3
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
PROPOSEDJIVIPROVENIENT'LO`GATION:, _'�r r .� _ -
Address:
%r440
S. C)UcLn_J)r
723
Legal Description:
Sand
.UoYox VLfics
O'ondomtnlLLm
A — unt
7a3
Property Tax ID#: 352oZ - (eoa- oo;a4-oo0-'i Lot No. ;&g 'I
Site Plan Name:
Project Name:
Setbacks Fr
Back:
Uld'ACLO RQ flau~
yT t4 1
❑HVAC L1Gas Tank
11 Electric D Plumbing
_ Right Side: _
Gt3=1
3erm it - cfeT;
Sas Piping
Sprinklers
Left Side:
"Shutters
EGenerator
Total Sq. Ft of Construction: . / S Ft. of First Floor:
Cost of Construction: $ ��f 1r7 Utilities:cnSewer 0 Septic
Block No.
INWindows/Doors
EIRoof = Roof pitch
Building Height:
OWN€RJLESSEE„
..
y a
CONTRACT R
Name
IeriOnza
14oQJ k T0.0. G
7- -
Name:
Address: a3ff0 P41MQ-rro Rd
Company:a'09WlGTci.A/
Address:/49�,?SIt2e71-V
City: r6-941T� State: 01:5,e-
Zip Code: SS2118 Fax:
Phone No. 15-&7 1917-"1/1b
City: k/es-06(m 600L'k State: fL,
Zip Code: 33,406 Fax:
-Phone-No. ( W) 77?- 207a,
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: Cr-.9.ee-raZ<2 �l7DC FG . C'O�f
State or County License: eda 65-93 S.2
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLL:EMENTAL
CONSTRUCTION"LIEN LAVU
INFORMATION,
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY: _ Not ApplicableA
Name:
Address:
Address:
City:
Zip: Phone:
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
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 Count yy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contlict 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 followingbuilding 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
STATE OF FLORIDA
COUNTY OF
The f g instrument was acknowledged me
thiF,�dayof VV'"P'e . 20/ �bY
STATE OF FLORIDA
COUNTY OF
The forge instrument was acknowledged before me
this ,Zday of iTUK 20 /7by
(Name of person acknowledging ) (Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known V OR Produced Identification
Type of Identification Produced
Commission
Revised 07/15/2014
(Seal)
MYCOMMISSION N GG VA886
EXPIRES: December28,2020
Bonded Thar Notary Ptffc Undemi"
(Signature of Notary
`Public- State of Florida )
Personally Known v OR Produced Identification
Type of Identification Produced
Commission No.
MELISA
EXPIRES: December 28,2020
BmW Thtu Notary Pipric Urde brs
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