HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONto %
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number: In - OQ RZI-f
BY
RECEIVED
St."LUcie CountY
Building Permit Application
Planning and Development Services OCT 12 2017
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential
Address:
Legal Des
Property Tax ID #: 1.0(, nCY001-00o-1 Lot NoC)0z/'6'
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: _ Right Side: Left Side:
Xnao U) Ro 0 1 otcom W±-
�.CtbN I -I S J10 . N
TRUC �lWbk]MATidN:,",, J
AachtionalWorKtollnirtormea unde-r-TispETm-it- check all apply,
HVAC Gas Tank In
E]Gas Piping Shutters Windows/Doors
Electric El Plumbing []Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S'c Ft of First Floor:
Cost of Construction: $ C:9 Utilities., n Sewer DSeptic Building Height:
C, 0 TRA
Name—PoIx
;l-Vct4XA[_un
MortotJ
Name: 21 0�z/ =e X_
Address: I I 'I)y KP_ Roo cL
Company: '64 a 7-;-1Je5e_S 1,4k4.
City: _K QA rJ Q. 6m' PO rt State:
ZipCocle: OqO4(a Fax:
� S(09- 4a-91
PhoneNo. (50a
A d d r e s s: 14;S_,? -z 16* 7W 725iZlinC /47 Z
City: — State:
Zip Code: S3 z178 Fax:
Phone No. 57&/
E-Mail:-
Fill in fee simple Title Holder on nextpage (if different
from the Owner listed above)
E-Mail: eeps?
State or County License:
I de- 65%5P3 5-1
If value of construction is $2500 or more, a RECORDED Notice of Commencement Is required.
,.�UOPLE'M"-E"N"T'AL'C�N-��-T,"R-' ION 0112NIAM
0 AMATIOW
:tpff
DESIGN ER/EN GIN EER: 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 Coun makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
Act with any applicable Home Owners Association rules, bylaws or an covenants that may restrict or prohibit such
which is in con, 1 9
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.f you intend to obtain financing, consult with lender or an attorney before
as
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTYOF
The fg& Wlinstrument was acknowledged before me Thefor was acknowledged before me
t s 1� 20 / i -
hi dayof '7aJ'#" 7— _Xy t h s �nd Way of V72�2-'Q=_ 20 /7by
-i:Z(rcO gic"Y"w6 nmoAm
(Name of person acknowledging) (Name of person acknowledging)
�Wjijffll <24 AAk&r_t�_ 'M' A �
(Signature of Notary Publit- State of Florida ) (Signature of Notary Public- State of Florida
Personally Known V/ OR Produced Identification PersonallyKnown IJ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No.
Revised 07/15/2014
MELISA ARMENTO
EXPIRES: December 28,2020
WOW Thri; NO" Pdlic UMMMIM
No.
MELISA ARMENTO
EXPIRES: December 28, 20M
Bw4ed Thm Navy Pit& Undeivdkm
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS