HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED,FnR ApNP�CDATION TO BE ACCEPTED
Date: BY Permit Number: 10
� s..` � , � ,-�.,•�; St. Lucie County
RE1: OVED
Building Permit Application OCT 12 2017
Planning and Development Services
Building and Code Regulation Division PERMITTING
2300 Virginia Avenue, Fort Pierce FL 34982 St; Lucie Co ty, FL
ntial Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Reside
Address:
r
Legal Description: 5"d-bollaA Vr lfa 5 Co n d o m i n I um 13— LM t 3 1 q
Property Tax ID#: 35olP— 6o5- oo1N- ocro_J( LotNo.sq/q/g
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK ;
a IOTG f
CQNSTRUCTION INFQRMATION:
HVAC L _I Gas Tank UGas Piping
Electric 0 Plumbing Sprinklers
Shutters Windows/Doors
Generator El Roof = Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 106 Utilities:'nSewer Septic Building Height:
OWNER/LESSEE .`
„CONTRACT R
Name I
61i 0 Of Q
Name:Y fj/q�Gia
Address: P. a. 60 443a'R
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Company:a'f q.ee_`TO/✓
Address:���is'iS
City: —My l State: 0'::' /--
Zip Code:.33 Fax:
Phone No. 5?'1
City: 0-112WI5ioa , FL State:FL
Zip Code: 33440-032sRax:
Phone No. Cg63) q S S ^ hq 1 I
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: 4rfA�2 , e;ep'n
State or County License: ryBC Oj 93 SB
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION' LIEN IA1rV INFORMATION;
.. _- .,
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
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 such
prohibit
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 wor cor I our Notice of Commencement.
s
Signature of Owner/Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The f ' instrument was acknowledged byre me
The forgoing instrument was acknowledged before me
thi day of 20 y
this.y of 20 /-7by
-L"L6 'Ml tm
V �rn,2�� rW.r Hhl
(Name of person acknowledging )
(Name of person acknowledging)
((SSignature of Notary Public- State of Florida)
(Signature of Notary Public -State of Florida )
Personally Known V OR Produced Identification
Personally Known OR Produced Identification
Type of Identification Produced
Type of Identification Produced
Commission No. (Seal)
Commission No. (Seal)
11 ,+"iyP"�:e"• MELISA ARMENTO
••P"fly°•.' : �MELISA ARMENTO
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MYCOMMISSION # GG 056696 a.( ;.__ ,My UUMMI55WN9CG056666
Revised07/15/201
EXPIRES: December 26,2020 z11oa,op: E%PIRES: December
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