HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 3d SCABN�NED Permit NumberAJ 1 o- d
--- —. St. Lucie County
Ste- J U
o Building Permit Applicatiop NOV 0 2017
Planning and Development Services
Building and Code Regulation Division BY: .......................
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Roof - S�"t r5,-
PROPOSED IMPROVEMENT LOCATION:
Address: '2t
Legal Description:
Property Tax ID #: 24 O(n - V',A I - oc *2xn - C)pc)- CI Lot No.
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Block No.
I DETAILED DESCRIPTION OF WORK: III
C?.en -\- w &_C6C)8. Qe_-C.0,1 deQ�:� C,as.
ar-6 cl� vn�kr\c&.l"V-ri • SrY2,Ya\\ TArOY.0 1nGlfS. SrfSi,-\\ n2W
\Scnlvs 06 ,A . U
1 CONSTRUCTION INFORMATION: I
ona,worxcooe
HVAC
Electric
errorrnea
unuertmsperrim-cnecKau
Tank E]GasPiping
Plumbing
apply:
_Shutters ❑Windows/Doors
Sprinklers Generator ® Roof '� Roof pitch
_Gas
Total Sq. Ft of Construction: iA S Ft. of First Floor: l o
Cost of Construction: $ Utilities: Sewer E]Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 7S&-,-P-�
Name: V
Address: '�Serm,n&e Q.A.
Company: Ler.1C
City: T--\• State:
Zip Code: oJ4g51 Fax:
Phone No. `
Address: ( fl 101 P-io/ hC,non - � rr-
city::BxA 2� e(C? State: rL
Zip Code: ?-3q Ci $"Z Fax: _+_1? ?(04-17'ia
Phone No.
E-Mail: (nCl I l(1-_k-,A • Cram
'Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: 1(, C i P C.n-ri
State or County License: rr I330G -;�
If value of construction is $250D or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: III
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: _Not Applicable
Name:
Address:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County 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
commencine work or recordine vour Notice of Commencement.
as Agent for Owner Signature of Contractor/License-Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 6A • L )0'4e COUNTY OF S* . I , iLt e,
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this � day of �liwtr,l �( 20 Eby this day of Km f . 20 1-+ by
1 Qo4 f4; c"n irA V. ei-11�E;
(Name of personaacknowledging) (Name of person acknowledging )
&0, 0 7rs 'Q i 0, , j lk'o
(Signature erNotary Pu lic- State of Florida) (Sign re of Notary Public- State of Florida )
Personally Known OR Produced Identification 1_ Personally Known _ r! OR Produced Identification
Type of Identification Produced IJI . Type of Identification Produced
Commission No. PORTmmission No.
o.;;tn S LLY ,o PORTES
S .:;"� 47625 ° �`e Commission a GG 47825
Commission A GG _
Revised07/15/2014 P°` November ls, 2020 Nam, November 15, 2020
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
1.2-�
COMPLETE
INITIALS