HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
SCANNED Permit Number:
BY
St. Lucie County RECEEVED
Building Permit Application OCT 12 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 Residentia
Address: ILI(o .9. bM0_n_-Dr- '7og
Legal Description; SWCL10110-ir V116, 11notoinrivyllam 3) — U�'t '702
Property Tax I D #: 3622- -16057-0059 -000-1 Lot No. J-101V D
Site Plan Name:
Project Name:
Setbacks Fr
Back: _ Right Side: Left Side:
1**LEDDE C I T64-OPWORK"'
6
[CONSIRUCTI'Ok INFORMATION:
E1HVAC LJ Gas Tank DGas Piping
OElectric 1:1 Plumbing OSprinklers
Block No.
1:1 _S�h u�t"Ite' rs INWindows/Doors
nenerator 1:1 Roof = Roof pitch
Total Sq. Ft of Construction: S Ft of First Floor: —
Cost of Construction: $ Z12 4 Utilities'In Sewer D Septic
Building Height:
OWN
FRJL�%EE: - � � - �� ','-'�"'.cbNTkA,,
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Name Gdlt
flnd"_'90y�
Name: 611,1W'e �
Address: ri -I 10 S . Ot2ouri-Dr. -D 7 0
Compariy:4:z��
City: — Twsan 89&ck State: F1_
Zip Code: 3 L1 q5rJ Fax:
Phone No. (1-7,j�) aac? - 0 cl 9 1
Aciclress�*� 5- IO&PI -72C-�r X/cze7;�'/
city: "rZ'Y" I State: ��2—
Zip Code: SS 4146 Fax:
Phone No. 15-&/ - :9917--71110
E-Mail:
Fill in fee simple Title Holder on next page I if different
from the Owner listed above)
E-Mail: Alz)De ee"'.'7
State or County License: 6746CI 657'23 5'1
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
UtblU INILK/ ItIMIL31 I%IttK: NOT APPiicaDie MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City:
zip:.
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: —
State:
Not Applicable
City: State:
Zip: Phone:
BONDING COMPANY: —Not Applicable
Name:
Address:
City:
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 conAct 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
commencing wc_rkoe �ecor C g your Notice of Commencement.
as Agent for Owner
STATE OF FLORIDA
COUNTYOF
STATE OF FLORIDA
COUINTYCIF
The f0jepin instnWotVcknowledged b*re me The f2or st . �strument was acknowledged before me
20 _��6y -7b
th!sL-) dayof I this —day of 1�57a'41'�Po 20 / y
1_ZChnV_() �V-xrhnnd c.hj2,&t)n
(Name of persoh acknowledging I (Name of person acknowledging)
(signature of Notary Frublic- State of Florida
Personally Known V/ OR Produced Identification
Type of Identification Produced
Commission No.
. MELISA ARMENTO
MYCOMMISSION#GGO
Revised 07/15/2014
I Wl� � i 44/J2"�-
(Signature of Notary Public- State of Florida I
Personally Known V/_ OR Prod, red Identification
Type of Identification Produced
M
MELISA ARMENTO
EXPIRES:
Bixidod Thrd N
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
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