HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r� _
Date: 10 1 LD Permit Number: IIn - n
arc, SC ANRECEIVED
St. Lucie County
Building Permit Application OCT 2 3 2017
Planning and Development Services PERTAITTING
Building and Code Regulation Division St. Lucie County, FL
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 III
PROPOSED IMPROVEMENT LOCATION: III
Address: B-Lac) N A-1 r API- 1LI-02 �T-L-- erce, FL �Wq49
Legal Description:'TIQrGL ► IPrS UYII-1:
Property Tax ID #: IW-2-5 - &%Q —QQR - CM --7 Lot No.
Site Plan Name: rti CkVn tCiWe'rS Block No.
Project Name: i'zr�P(l R��idCf-CP
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
-Rcrnov4E and r-cplace 5116ing Glass
doors. (2)
N INFORMATION:
❑HVAC Li Gas Tank ❑Gas. Piping
Electric 0 Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 15 ,= • Co
Shutters .E�J Windows/Doors
Generator 11 Roof = Roof pitch
S Ft. of First Floor:
Litilities:ll Sewer ElSeptic
Building Height:
OW N E RAESSE E:
CONTRACTOR:
Name Fyan
Name:10old InRrrloe-
Address: 3l510 N. PclA 1402-
Company:`r%lt? ciasC ??t'b&ts3it'91KdIS
City: F+ Ti erc&- " 'i State: FL
Zip Code: 34(*4q Fax: i. ict
Phone No. i12^Pia ^ L4 lqq
Address:' 70' SE N Xi i :. -H WV
City State: FL -
Zip Codiiill 34gQ^I '== . Faz:-'J7Z.' 286-04(o
Phone No. -17Z - 2910'OL�5q
E-Mail: h a 0 ccl-n
Fill in fee si le Title Holder on next page ( if different
from the Owner listed above) ` ',- ,,.,.,State
E-Mail: pros;` Q
or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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.
no
e the permit holder to build the subject structure
or and covenants that may restrict or prohibit such
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
comm ce il�tork or recordine vour Notice of Commencement.— (1 t
as
STATE OF FLORIDA STATE OF FLORIDA , �/� L
COUNTY OF PML+ h COUNTY OF 1 r 1�i�7 i Yl
The foQrgoing instrument was acknowledged -before me
thisLdayof Ce'}Qr�!� 20 Llby
person
(Signature of No Pub ic- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
Revised
Assn.
The forgoing instrument was acknowledged before me
this 1(a day of f 1Nnb2,r , 20 k^% by
(Name of person acknowledging)
(Signature of Not
Personally Known
Type of Identiffcat
Commission No. _
of
OR Produced Identification
KELLY WIDMAN
Mary Pub(ke0JI�te of Florida
Commission # FF 929255
National Notary
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