HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
SCANNED Permit Number: 1 /I -i� 6
t3Y RECO ED
St. Lucie County
Building Permit Application OCT 12 2:
Planning and Development Services
017
Building and Code Regulation Division PERivIIT-7i&4G
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie Co tY, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
I PROPOSEj).jMPROVEMENT.-LOCATION _
Address: 140o S. 1)C4.0Xl__1 f . n5o I 1
Legal Description: Sb_ocl�Q (IDX' U; I (as t_DYtdom i llit w 4"' - ii ± Jr Oi
Property Tax ID#: 3Saa - Go& - ooI(o-oo0-I LotNoJ�O.�
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK '' -
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CONSTRUCTION INFORMATION:
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❑HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
❑ Electric ❑ Plumbing ❑ Sprinklers ❑ Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: ,,Sq. Ft. of First Floor:
Cost of Construction: $ /T//S Utilities: Sewer ❑ Septic Building Height:
OWNER/LESSEE
`kCONTRACT R.
Name
2f Q SQ
Name:
Address: 1 aP f.
Company:a//le_,-_7 >A/ �eOT��GSI.G�C'.
Address:/e��IS 10&7 / %�IUdC� �OGTN
City: �'`(l/°/TIC State: �L
Zip Code: S3418 Fax:
Phone No. 5761-
\)
City: iaY'ME' LklliAA State: M t
Zip Code: Ln 4 001 (o Fax:
Phone No. co1o%) BL4(9-gao(-a
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: Grr<A�L�i*f� �G?r7C FG . L�On/
State or County License: eBC 0 ?3 S/
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFQRMATION`s
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY.
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone:
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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 Count yy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contlict 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
commencing worker cf�or Ibe your Notice of Commencement.
as
STATE OF FLORIDA
COUNTY OF
The feyrift instrume tw s�cknowledgedbe re me
this_day of FJ " 20 L y
STATE OF FLORIDA
COUNTY OF
The for nstrument was acknowledged before me
this day of 20 lXby
-L 4 NA D�ay 11� tr va f(A cyia' 1-1 otn
(Name of person acknowledging) (Name of person acknowledging )
(Signature of Notary Public- State of Florida )
Personally Known VblOR Produced Identification
Type of Identification Produced .
(Signature of Notary ,Public -State of Florida
/)
Personally Known t/ OR Produced Identification
Type of Identification Produced
Commission No. (Seal) Commission No. (Seal)
•;:_;%'•• MELISA ARMENTO ; op'Y"••o MELISA ARMENTO
MY COMMISSION # GG 05688 : + ;,? MY COMMISSION # GG 056886
—Revised07/15/2014 EXPIRES:OxxW 20
December �:gr:t„: a«aedmNrio P cunazen s
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATILIME MANGROVE
COUNTER . REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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