HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
SCANNED
Date: BY Perm it Number:' 7 -
P77:..1745 T St. Lucie County
Building Permit Application
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
Address: De1LQt1.1Dr, oj- LL
Legal Description: SQndt l�ollnw V,IIQS LtmOIOM�nI l E - htn'&b 7oa-
Property Tax ID#: 35aa- 6016-0QA5_-000-3 Lot No. 7q;i 4t-:--
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK ,
CONSTRUCTION INFORMATION;
Additional work to e uertormed under tispermit-check all apply.
❑H) Gas Tank []Gas Piping _Shutters Windows/Doors
11 Electric 0 Plumbing ❑Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: �//� S Ft. of First Floor:
Cost of Construction: $ �T� Utilities. D Septic Building Height:
bWNWLESSEE ::. _. "
'CONTRgCT R
...
Name I�tlliwrn
i�OSSOXI
Name: ff
Address: �.0• LS4fa
/�
Campany:67iiACG n' e�eDT�/�GS/ '•
Address:/6�SS/Oa7,-V Tf i��<,�loGTN
City: O� State: ✓1�
Zip Code:33 4146 Fax:
Phone No. 67 - ✓�3`7--zl10
City: O1Ji0t11P. State: NLl.
Zip Code: I.'ll3`i Fax:
Phone No. (518) R 6 a — 60 (OE
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: A/OroC FG , elp"n
State or County License: eWC- dj 93 S/
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION`LI,EN' LAWN INFORMATION`.
DESIGNER/ENGINEER: 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 County 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 such
prohibit
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 wor ecor 1 our Notice of Commencement.
s
Signature of Owner/Lessee/Contractor as Agentfor Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The fyrggg instrume t wasgcknowledged bee me
The for strument was acknowledged before me
this r� day of y
this rS day of , 20 L;nyy
/�%kf� ( 12,0� ,_
-LZ l'MI(c1 liY ay `W
/`f(%gre—�
VCyAny � CY 11d1J(� 1lJ( 1
(Name of person acknowledging j
&442A2 ,. �( mil/
(Name of person acknowledging )
��C C/YI "_PAiE�)'
(Signature of Notary Pub' -State of Florida)
(Signature of Notary Public -State of Florida I
Personally Known OR Produced Identification
Personally Known `.I/OR Produced Identification
Type of Identification Produced
Type of Identification Produced
Commission No. (Seal)
Commission No. (Seal)
•�'fi:°�'•. MELISA ARMENTO
•. qPW • MELISA ARMENTO
• ,F MYCOMMISSION #GG056586
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SION#GG066886
Revised07/15/2014
': _ EXPIRES:December28,2o20
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�V16.01..tC.
EXPIRES: December 28,2020
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BadBdThnJNomry Pubk Urderkriais
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