HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO.MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: !j /7 Permit Numbe
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SCANNED
BY
St. Lucie Countv
Building. Permit`Applicat
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Planning and Development Services ���, ,,,.WI .MigiG
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: S�no-�}eiS-.Gar.
Address: 9yS�a MCtr�iwod�D/ nnf� 2J/
,
Legal Description: f2ugt)l.azepi AAA
Property Tax ID#:
Lot No.
Site Plan Name:
Block No..
Project Name: ,({ e GrJ
Setbacks Front- Back: Right Side: Left Side:
ClpJri a G� mom, n OHM/ .,� A!C C�l� �G// �-i1 Fi�o6so�
Additional work to ne performed un er t is permit —check all that apply:
_Mechanical _Gas Tank _Gas Piping Shutters
•Windows/Doors„ .'.
Electric _ _ Plumbing _Sprinklers _ Generator
_ Roof
Total Sq. Ft of Construction: Sq. R. of First Floor:
Cost of Construction:$ S,�y7 Utilities: _Sewer _Septic
Building Height:
Name e e-f
Name:
//
Address: M6sd4r%Osb / vn1 . ems/
Company
City: r/!t State: F/
ZipCode:Fax: of//-9
Phone No.'72 - �� _ %L{D i/
Address:
City: -IF/, it/lam__ State: f�/
Zip Code: .3 y%Z% 6 Fax: 7%?- 4/616'8S3
E-Mail: a -lw
Phone No.
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: %�ovYlo
)e 0420 . Con,
State or County License: SCC
/3%/3 /,SO
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
PDEMSIGNER/ENGIN`EER: Not Applicable
MORTGAGE COMPANY:. X Not Applicable
Name:_ptv40 ih "trsa
Name:
Address: D D of
Address:
City: 1ci« State: F
City: State:
zip:It/9S'-0 Phone: 274-267-/799
Zip:. Phone:
FEE SIMPLE TITLEHOLDER: T Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City. .
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 restrict
may 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 work or recording our Notice of Commencement.
ignature of 0 r/Agent/ Lessee —
ature,of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF `-sk_ L\)c Xt
STATE OF FLORIDA
COUNTY OF 5
The forgoing instrument was acknowledged before me
thisX� day of Qe r 20 by,
The forgoing instrument was acknowledged before me
this `� day tky_
of 20 by .
t
\\N0V"a.S J�i.Vb\L
(Name of person acknowledging)
(Name of person acknowledging)
so� law-d,�
(Signature of Notary P c- State of Florida)
(Signature of Notary blic- State of Florida )
Personally Known OR Pro to «- ;
P sonally Known OR Prgduced Ideotdisatsfe
Type of Identification Produc "! 4v A ee,u^2n
3T a of Identificatio , b
'gn .er h��. cDncet^.oet1�'
Commission No.L;5�1 a
rx (S�adSN,�Nxn'y ntocl .en•
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"' mission No, a a0- b Seal
BondedThN N°t"h
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
RECEIVED
COMPLETED
ev.