HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: SCANNED Permit Number: /7/0• m/OQ�l
BY
�' «"" St. Lucie County tCVE®
AW Building Permit Application
Planning and Development Services OCT 12 2017
Building and Code Regulation Division PERM17y G
2300 Virginia Avenue, Fort Pierce FL 34982 St Lu ie
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ResidentlaP n FL
Address: 00 St O_V) Z)rp. 303
_
Legal Description: SMot Do 11 .r V i 1 ICiS lD r1Ao rn i n i; /YI
Property Tax ID #: 3 Sap - (oob -Oo I o - Ooo 5 Lot No. •3 r=
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION:OF WORK
.�IrLndow RQflacLmwt Ga =a
.� TdtA I
CONSTRUCTld&INFORMAT ON
itiona wor to e errormed under tispermit-check all apply:
11HVAC Gas Tank ❑Gas Piping _Shutters LaWindows/Doors
11 Electric Plumbing []Sprinklers 1:1Generator 1:1Roof = Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ ,f
S Ft. of First Floor: _
Utilities:12 Sewer E]Septic
Building Height:
OWNER/LESSEE y
CONTRACT R
Name co 2 o I
Name: �Gr� �qea%o
Address: E)rooOd Sb
/�
Company:C�i�//,eGi73it/ BeOTH�GS/.mac'.
iLi14
City: �[Js6Ttggaes. State:
Zip Code: 11154 Fax:
Phone No. (03 i1 333 - 6a=
Address :14LrOS10&72/ l£,�locTN
City: State: �L
Zip Code: -33 ` 18 Fax:
Phone No. 67 ✓3`�-%/lC7
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: Lep n
State or County License: edC 65-e3 S/
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
,,. ..
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION`, , -
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
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 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 wo cor I vour Notice of Commencement.
as Agent for Owner
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTY OF
The f B instrument was acknowledged b ore me The fore instrument was acknowledged before me
thig� day of J�(�.t�� . 20 ,Lpy this J day of 20 i iby
1Q-�Ind UchA\1-d CVVX\'Vvn
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Puubblii State of Florida )
Personally Known V OR Produced Identification
Type of Identification Produced
Commission
MEUSA ARMENTO
(Signature of Notary Public -State of Florida ) /
Personally Known V OR Produced Identification
Type of Identification Produced
Commission No.
-Revised 07/15/2014 Mai EXPIRES: December28,2020
.,,.. �w' Omdod tlw Notary Public Undenniters
(Seal)
MY COMMISSION # GG 056886
EXPIRES: December 28, 2020
Bonded Tbnt Notary Public UndermMPS.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
//4-47
COMPLETE
INITIALS
6-40