HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number: 17/ O- 17 wZ f a,
BY
St. Lucie County
o` RECEIVED
Building Permit Application OCT 1 y 201�
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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PRQ?OSED IMPROVEMENT LOCATION.
Address: 7 LfZo S . nee" -b r/n.� t7 ► I
Legal Description: Sand Lollar Villas Uun, rill
Property Tax ID#: 35aa— (no 4- oo36- DOO-7 Lot No. %11r
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
CONSTRUCTION INFORMATION
AuanaonaiwmKwue enurrnea unuer ims permit—cnecK au appry:
❑HVAC _Gas Tank ❑Gas Piping _Shutters IxWindows/Doors
11 Electric OPlumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: ScFt. of First Floor:
Cost of Construction: $ c7 `f J� Utilities:Sewer E Septic Building Height:
OWNER/LES$E€
CONTRACT R:
Name
Name: TO
Address: a!i 1A E.WbkpAe.
194 1
Company:e5'11We.,e_'7V1V �COTHe��S/.�C'•
Address:/6�i_S IC&7- 771256&�IIOZ7W
City: �'`(J/°/TEC State: ��-
Zip Code:33 418 Fax:
Phone No.5-67
City: SioU-c Yct ils State: S
Zip Code: E71 DS Fax:
Phone No. tv 8u5) 309 -3 I o 3
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: 40n
State or County License: 466 05_93 S/
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN'LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State: _
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 Countyy 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 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 1 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 fo-) da(finstrgp�n���acknowle200ed hefyre me
thisJ_ da of if[_X
STATE OF FLORIDA
COUNTY OF
The forgoi//n�� instrument was acknowledged before me
this. -day of ' /r6/!� , 20 �7by
N `Icmo e nyy . '1 Vchawl cl�Qll =
(Name of person acknowledging ) (Name of person acknowledging )
If
(Signature of Notary Public State of Florida )
Personally Known y OR Produced Identification
Type of Identification Produced
Commission No.
(Seal)
(Signature of Notary Public -State of Florida )
Personally Known V%OR Produced Identification
Type of Identification Produced
Commission No. (Seal)
1141
¢ MY COMMISSION# GG 056886 &. .� MY COMMISSION# GG 056886
Revised 07/15/2014 ;� p; EXPIRES: December 28,2ozo I+'11 o�" EXPIRES: December28,2020
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