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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICA/BLLEE I FO MU E COMPLETED FOR APPLICATION TO BE ACCEF�n- IED Date: L/ I� Permit Number: or,, ®©�G SCANNED BY OCT 12 2017 St. Lucie County Building Permit Application itting Dept. St. Lucie County, FL Planning and Development Services 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 W In S Address: PropertyTaxlD#: 4j53]2--5Q7--QDZ5--CM-,5 Lot No._ Site Plan Name: Project Name: _ Setbacks Front Back: Right Side: Left Side: Block No. Remove o r1c1 reel c�c e (3� i m J7C�C�- s i 9 l e +1u"q windows HVAC U GasTank- Electric 0 Plumbing Gas Piping LJ_Shutters- Sprinklers ❑ Generator Windows/Doors Roof = Roof pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ �J, 2� Utilities: Sewer Septic Building Height: r{• SEE",.yi� f n rc �rr�^ d. �[.+ ti? f'� �j','�`rJ� r� +', P �'„;ct'✓�3^"'x .e4� M1' �F})j''` #'+� .°I4.sf X Name Pi.l11+ ef-ph ne ►liE) f' t-nl Name: Address: 3M N W , nay i (-\N I MY ) e S Company: :D' 6 rrt 0l� PI��qRaxe City: i.'r1nPi V, State: a Zip Code: B4 F�I.o Fax: tvIft Phone No. --1-72- �i- 2-7'3 Address: 35-!0 C E T-) I X 1 C� : -:fl \AJ�J 4 1 City: S-EiJnr-k- State:,±�I.- Zip Code: _a�Rq-1 Fax: 2-SID-041D1 Phone No. ,-7Z - 2S(0 - 045 LI E-Mail: N I Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail: per L��� -13 OC qrnotiP State or County License: 193(n;� If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. Iq DESIGNER/ENGINEER.,, No'tAppileable MORTGAGE COMPANY; �.Not Applicable Names. Name: Address:. Address: City: :.. _ . State: City: _ State: Phone __ _ Phone: Zip: .'Phone: FOB 51MPLE TI T Le HOLOM - Not Applicable BONDING COMPANY: yNot Applicable Name:__ Name: Address:— Address: City: City, Zip: _.� _-----_ Phone: Phone:_- __--- ._-- _.----. blkiNi R/ CONTRACTOR APFIOVIT: Application is hereby made to obtain a permit to do the work and installation 05 intlitated. I certify that he work or Instaliauon has commenced prior to the issuance of a permit. St LgdI6 CdunttV�1 rrfakes ho iepre3ent2addh that is granting a perrAlt III authorise the permit heideP to build the subject structure Which Is In q"onfllot with any applidable Home Owners Association rules, bylaws or and 'covenants that may restrict or prohibit such btrueturo, Please consult With your Home Owners Association and review your deed for any restrictions which may apply. In eansidetdtibn of the granting of this raquested p@fmlt, I do hereby agree that I Will, in all respaets, perform the work In accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are oxtrnpt from undergoing a full concurraney reviaw: room additions, aecessory structures; swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-tesidontial use WARNING TO OWN99! Your fdiiure.to Record a Notica of €arnf"eftceertieht may result Iri your Paying Evtrice f, Improvei�bAts to your�iropaty N61:10 of Cf0f``liirionea rtpnt P;w be re€drded And pasted d the Jobi befe too First 113 db€thin: If end to UbtlIb f1Ft6rl ;M, ttbgult With ldhd6f C before Sig-nat'ura of 0wneP/.L'da5ee/Cofitractof 65 Agent for OWhar Slgnattlra Of Cohtfadtdr/LlCense Holddf STATE OF FL6RIp� STATE OF FLOR COUNTY OP i 1 Ka1Y i o COUNTY The fgPoOlng lnstruittent was ael neivledggad before rite the ,f�i@oInt I �Lrijmer t was a kriew edged wara Fie this a of 24 fi thlslfdayof� 2613b y / .. A n _ liL 2S.) �' Personally Rnfswr, _. N OR PI'MU ad ivantificatian t r par:tnnaNy known F 0R praduited Idantifiedtian - Type of Itibmifieatioh Type of Idfentlflcatlod Produced Produced . , . — — - , . 1 .. A (Signature of N&V Public, State of Florida ) I (Signature of Ni t�J,ty Publics State of Pl6rida ) Commisslon Notary Public - Stale of Florida Notary Public - State of Florida