HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED PermitNumber: 1-11LO-Oal�
BY
St. Lucie County RECEIVED
P I lanning and Development Services Bui ing Permit Application XT 12 2017
Building and Code Regulation Division : F�_V' 1
2300 Virginia Avenue, Fort Pierce FL 34982 SL Lu..�t9
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Resiclen-_
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address:
Legal Des
Property Tax ID #: 35.2.1 - 6 05 - oO 36 - ocie) -o Lot No. -76l:5'_P
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: _ Right Side: Left Side:
111-11 1]Gas_T__a_nk_____ -1 --- 1'G_a_s_P_1_. g ____ E]_S�h�utlters Windows/Doors
11 Electric D Plumbing OSprinklers 11 Generator Roof Roof pitch
Total Sq. Ft of Construction: S'c Ft of First Floor:
Cost of Construction: $ C::� Utilities. nSewer OSeptic Building Height:
tOWNERAESkL-�'z's '-.' , ;' 1
-�CONTRACTR R:'.
Na me F&an 45: ('nrac�xoun
Name:
Address: L4 I I) n ta a 16 --b r.
Company:aA4e_'_'7-z;'1V
Acldress:,�S_ 1(5&7,-'t
City: 'rC-,V, I State:
Zip Code:93 217�8 Fax:
Phone No. 5-&l -
City: 1411cisow State: M A
Zip Code: 0 1-749 Fax,
Phone No. (9720 (.19-ra-773
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:
State or County License: 674d6 C5-473
if value of construction 15 $2500 or more, a RECORDED Notice of Commencement is required.
��PPLEMEINWALCONtfklll)CTIQN_ LIEN LAW INFbRMA,1I0N-
DESIG NER/ENGI NEER: Not Applicabl OR GAGE COMPANY: Not Applicable
Name: e Na m e�.:
Address: Address:
City: State: City: — State:
Zip: Phone: Zip: _ Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
—NotApplicable
St. Lucie Count makes no representation that is granting a permit will authorize thegermit holder to build the subject structure
which is in conAct with any applicable Home Owners Association rules, bylaws or an 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 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
as
STATE OF FLORIDA
COUNTY OF
The fqrgV�&instr as aCknowledged before me
thismday 20 OrAy
STATE OF FLORIDA
COUNTY OF
The for92' . ristrument was acknowledged before me
AlIvi
thls.��c ray of 20 1*7by
-;R\Cha f6 (1\aabn -2�\m�d Ckoxftn
(Name of person acknowledging ) (Name of person acknowledging )
wplmA c;4.'4J'q;2— 91LA��
(Signature of Notary Public- State of Florida ) (Signature of Notary Public- State of Florida )
Personally Known V/ OR Produced Identification Personally Known V11"OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No.
MELISA ARMENTO
OMMISSION # GG 01
Revised 07/15/2014 Bor&d Thm NoWy Pubfic
MELISA ARMENTO
Pubk
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS