HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: "' )�7 Permit Number: V e 27�7
SCANNED
BY
St. Lucie County
Bui ing Permit Application OCT 2 2017
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
Address: 7q2Q 5- ftoi) Ir. 1+114
Legal Description: Sandbollov Villas 0onclotm*imam C - "*& 14,14
Property Tax ID #: 36Z19, - bcL4 -no ;Li - 000 - q Lot No. �114
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
0 PWORK?`�",
DETAILED DESCRIh �',W,6
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ftmmit'�l ... �'w t� h. '-d- +hr�
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6,9 �-"-
E1H`VAC 1-1 Gas Tank E]Gas Piping L-1 Shutters
11 Electric 1:1 Plumbing []Sprinklers DGenerator
Total Sq. Ft of Construction: S Ft of First Floor:
Cost of Construction: $ Z-11-14 — . Utilities,12 Sewer 0 Septic
rVI
L& Windows/Doors
0 Roof = Roof pitch
Building Height:
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Name iiiLharnl
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Name: -
U
Address: P.O.
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Company:&7,,9We_.,_7Z>/V
A d d re s s:163-,_0 5- /Cj�, 7,y -rj5�� .11cZe7?V
city: '72-v'/ State: 101=_-�_'
Zip Code: S3 418 Fax:
Phone No. 57&/ - _1911--XV0
City: Naccia State:
ZipCode: 31-108' Fax:
Phone No. (L418) 714? - 2 (3 0
E-Mail:
Fill in fee simple'ritle Holder on next page (if different
from the Owner listed above)
E-Mail: A'�Dzie e'L>'-k7
State or County License: e466 05V3 5-1
If value at construction isSZ500 or more, a RECORDED Notice of Commencement is required.
,-S I U I PPLEMIE""' Lt6KSfRUCTl0N LIEN"LAWIN - FO RMATION.,
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 Count makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in conWict with any applicable Home Owners Association rules, bylaws or an9covenants 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
commencinR work4a �ecor I g vour Notice of Commencement.
as Agent for Owner
STATE OF FLORIDA
COUNTYOF
STATE OF FLORIDA
COUNTY OF
Thef nstrument was ac now edged I*re me The forgoin
r
,g instrument was acknowledged before me
w 2.0 Z-Zy this-5Wd'ayof 20 1-7
this _ day of b
Y
1�2 �Chavd CW�i�pn -C
")(J C Aclrftn
(Name of person acknowledging (Name of person acknowledging)
�Uip)i'a6a' CA -J"Z4:9= Udi.4q, SA AAIUAA5�—
(Signature of Notary Public- State of Florida ) (Signature of Notary Public- State of Florida )
Personally Known V OR Produced Identification Personally Known V10, OR Produced Identification
Type of identification Produced Type of Identification Produced
Commission No. (Seal) I Commission No._ (Seal)
MY COMMISSION# GG 056886 MY COMMISSION# GG 056886
Revised 07/-15/2014 41 EXPIRES: December28,2020 57j EXPIRES: OMMNr28,2020
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REVIEWS I FRONT ZONING SUPERVISOR I PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS