HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: /0 - Z,�_ /% SCANNED Permit Number: I N l In 0 W'3'1 ')L
BY , Eg sr^
St. Lucie County ` nw t
Building Permit Application OCT 2 5 2017
Planning and Development Services PER:NITTING
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
Address: c/y00 S- OCEAti/ D12rvE T I^N5" /?rgcy 3Y95--7
Legal Description: 04f-I,N iaW $2S &nA� 4
PropertyTaxlD#: ,357-3r- %fJ/— 0000- 000—q Lot No.
Site Plan Name:
Project Name:
HVAC IJ Gas Tank
Electric 0 Plumbing
Block No.
Piping ❑_Shutters Windows/Doors
nklers 11 Generator 11 Roof
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of construction: $ 2 0i 3� Utilities. Sewer Ll Septic Building Height:
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Name IV, . •. 1
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city: State- FL-
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Zip Code: i
Phone, •
Fill In fee simple'ritle Holder on next page (if different
from the Owner listed above)
E-Mail: bi�11111 - q-
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If value of construction Is $2S00 or more, a RECORDED Notice of Commencement Is required.
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Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
Zip: Phone:
I certify that no work or installation has commenced prior to the Issuance of a permit.
Applicable
St. Lucie Counter 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 agreethat 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
_ Signature of 0 ner/ Lessee/Agen
STATE OF FLORI A
COUNTY OF ., / ', e—
The forgo' g instrumen was acknowledged before me
thi �y of d, b _ 20 /�by
(Name of person acknowledging) '
Q.,�, 24
(S" at reofNotaryPubhc-StateofFlorida)
Personalty Known OR Produced Identification
Type of Identification Pr duced
Commission No 9 tft%tyh;: (y nc NNE K MATTO
MY `C MMISSION # GG01
a cxvIRES May 28. 202
Revised 07/15/2014
STATE OF FLORID / � �
COUNTY OF L (AP( ( �
The forgo g instrumen was acknowledged before me
thi T2ay of J 20 JZ by
Ki? n neA /-{- 6,- l 7s�C
(Name of person acknowledging)
" I t6i a,�74—_
(Sign re of Notary
_Public- State of Florida )
Personally Known OR Produced Identification
ILae of Identificatio Produced
No.�ON#GG09C
9 MY CO 28� 2021
cvoIRES May
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