HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number: 93
BY
' a St. Lucie county
e
Building Permit Application
Planning and Development Services '
Building and Code Regulation Division l
2300 Virginia Avenue, Fort Pierce FL 34982 J
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
Address:
Legal Des
Property Tax ID #: 35c] of - 606 -00-43 - 000 - Lot No.90/J45
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
CONSTRUCTION INFORMATIONt
itiona wor to lie e rtormed un ert ispermit-check a apply:
0HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
11 Electric 0 Plumbing Sprinklers ElGenerator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 144y
S Ft. of First Floor: _
Utilities: Sewer E]Septic
Building Height:
'Name:
Name Mir-6a 2 I
R9C¢ h
2
Address: 14 StKti-t1
0p //F�
IIVO.nu.L.
Company:e,09Wt-G7ZP/✓
Address:/4L-1i4S10&72/ We7,C7;4
City: Rizo-ni rr. State: C I
Zip Code: 0(o t{O$ Fax:
City: �*'(J/°/T State: �L
Phone No. $fo0� RR9 - q7q 3
Zip Code: 33TPi Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
E-Mail: ep'-q
State or County License: 6746C 65 93 S/
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONS7RUCT10N' 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 County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in con Act 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 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
commencine wo ecor I vour Notice of Commencement.
as Agent for Owner
STATE OF FLORIDA
COUNTY OF
The fo-cg9fWnstrument was acknowledged be re me
this L5 day of /�/� 20 / y
STATE OF FLORIDA
COUNTY OF
The for of instrument was acknowledged before me
thi day of 20 _L7y
1 haLrd C11.. d±M 9-1 CXard aw ftn
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known � OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15/2014
(Seal).
MY COMMISSION # GG 056888
EXPIRES: December 28, 2020
-Boded lieu Nobly Public Undervmtais
gq
(Signature of Notary Public -State of Florida )
Personally Known � OR Produced Identification
Type of Identification Produced
Commission No. (Seal)
` MELISA ARMENTO
EXPIRES: December 28,2020
Bonded mN Notary Public Undenydters
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