HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED
FOR rPUCA11ON TO BE ACCEPTED
Date: �/_ �_I�
CANNED
BY Permit Number: l
St
Lucie County RECEIVED
... Building
Permit Applicatior NOV 13 2017
Planning and Development Services
Building and Code Regulation Division
Permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1
c, � ,"
78 Commercial estlt ntia ty, FL
PERMIT APPLICATION FOR: To S
alect from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCH
ION:
Address: /
'k
Legal Description:
Property Tax ID#: ya?.— '45
36s— 000—a Lot No.
Site Plan Name:
Block No.
Project Name:
Setbacks Front Back:
Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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NK 9�✓,) Ll PJ
CONSTRUCTION INFORMATION:
rtiona wor to a orme un er
is perm it—c ec a app y:
I�HVAC Gas Tank
❑Gas Piping _Shutters Windows/Doors
❑_Electric Q Plumbing
Sprinklers 11 Generator Roof Roof pich
Total Sq. Ft of Construction:
Sq. Ft. of First Floor
1:1
Cost of Construction:$ oZ �U
Utilities: Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 72,02 TLA
eC r S
ame: /2i L.
Address: l ✓ ' L.
• CJ 1
Company: vn )P 62
Stater
Address: % -7 6 6 e)
� pr-erLi..
'.. City:
_
Zip Code, Fax:
City: ( P1?[_S SA/✓ State:_i�
No.
Zip Code:?d '74� Fax: .Tap 6 ADO
Phone
E-Mail:
Phone No. '%%L . 3 t3 9 6U6
(if different
E-Mail: Fy2 i° c ( C/ I197
Fill in fee simple Title Holder on next page
from the Owner listed above)
State or County License: fir] ref
If value of construction is $2500 or more,a RECORDED
Notice of Commencement is required.
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I
SIJPPLEMENTALGONSTRUCTfQiV LIEN LAW INFORMATION
DESIGNER/ ENGINEER: _NotAppliwbie MORTGAGE COMPANY: —Not Applicable
Name:
Name:
Address.
Address:
Cam' State: City- I
_ State: _
ZIP:' Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY:Name: _Not Applicable
Name:
Address:
Address:
City:
City: I
Zip: Phone- Zip: Phone'
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain ape'
I certify that no work or installation has
to do the work and installation as indicated.
commenced prior to the issuance of a perms
St Lucie County makes no representation tbat is granting a permit will authorize the
which is in conflict with any applicable Home Owners Association rules, bylaws or an
structure Please consult with your Home Owners Association
hermit holder to build the subject structure
covenants that may restrict or prohibitsuch
and review your deed
for any restrictions which may apply.
In consideration of the granting of this requested permit, 1 do hereby agree that I will(
In accordance with the approved plans, the Florida Building
in all respects, perform the work
Codes and St Lucie CounityI
Amendments.
The following building permit applications are exempt from undergoing a full concurr
accessory
ncyreview:roomadditions,
structures, swimming pools, fences, walls, signs, screen rooms and accessoryuses
to anothernon-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencemen
Improvements to your property. A Notice of Commencement must be
may result in your paying twice for
ecorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with
nder or an attorney before
commencin work recording our Notice of Commencement.
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SI att�Fe" 06 caner/ essee/Contract for owner
Si re of ¢ "nt
ac tens Icier
STATE OF FLORIDA�
COUNTY OF
ORIDA
OUTNTY OF
I r /L C
The foygping instrument was acknowledged before me
this C.f'dayuf n7U- 204j'ty
The fo oing instnYment
this
was acknowledged before me
IN�h1't./,r�
day of
.20�by
- �N r7
Name of person makingstatement
PersonallyKnown Y
OR Produced Identification _
Name of
Personally Known
person making statement
-4 —OR Produced Identifiwtiogr
Type of I entification
Type of Identilicat
on
Produc 1Ak Z 7
Produced„LYZ
(sl6a �. �9' Po010809e g 4fr4b,
(Signature of Nota
y Publi, L of to id
•9 My Comm. Expires Ma 7
s-' 3? Cam�l�yace�� 8 FF i2 f �e
"'•,gam,^ ay
Commission No.
,>.�"'L;'•. SHERBYTWMEY
PuhliES�eol Florida
.F - Bonded lNouyh NmlvW NotaryAssn,
-_ My Comm. Expires May 19, 2016
�Commi
?_> commission N FF 124535
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEG
MANGROVE
E R
COUNTER
REVIEW
REVIEW
REVIEW
REVI
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
tev. 8/2/17
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