HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICE I FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED e�
Date: AB SCANNED Permit Number:
- - St. Lucie County
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial X Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMP-ROVEMENT LOCATION: -
Address: Say o.brfl
Legal Description:
Property Tax ID #:
Site Plan Name: _
Project Name:
Setbacks Front
3
39H9- a8 77
V,0a3a- 000 -7
Back: Right Side: Left Side:
DESCRIPTIONDETAILED OF •'
CONSTRUCTION INFORMATION:
AUUILIUl1dl WU1KLUUe
enorrnea
Gas Tank
unuerimbperfmL—McGKall
Gas Piping
apply:
_Shutters
�EIylHVAC
Lit Electric
Plumbing
Sprinklers
1:1Generator
Total Sq. Ft of Construction:
Cost of Construction: $ g595 00
5 Ft. of First Floor: _
Utilities:Sewer F� Septic
Lot No.51
Block No. IL/_
Windows/Doors
ORoof = Roof pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name,
Address:3 44 <LSVIAg2a
Name:
Company:!�
City: � J State:
Zip Code: 0,094G Fax: -
PhoneNo.772-318-955L
t�
Addres�sj• A.
City: Per t-L) State: p
Zip Code: "_ Fax: <lta/•9770
Phone No. #G I- �-277
E-Mail: elri3lanqpl 0 Q 11.
Fill in fee simple Title dolder on next page ( if different
from the Owner listed above)
E-Mail:,M,)/e&, Q&,A Ai 0o,40 MM
State or County License: LFGf /_3100 -.r8.59
If value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
71
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: �� IA
MORTGAGE COMPANY- _ Not Applicable
Name: AJ �A
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLD: _ Not Applicable
Name: a1 I la'
BONDING COMPANY: I _Not Applicable
Name: nl 1
Address:
Address:
City:
City:
Zip: Phone:
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. ]�� intend to obtain financing, consult with lender 0'21 attorney before
i commencine work or recor dnelvour Notice of Commenrement_ / 1
as
STATE OF FLORIDA , STATE OF . I L"� COUNTY OF FLORID
+ ,I .
COUNTY OF SA' �LJ
The for Pg ing instruj�mne�nt was acknowledged before me
this Kay of J.KCton " 20 Mby
person
i/L'11�
Notary Public -State of Florida )
The forgoing instrument was acknowledged before me
this �i W day of C)ECZr'h 6" , 20 J-f by
person
Notary Public- State of Florida )
Personally Known ✓ OR Produced Identification Personally Known y OR Produced Identification
Type of Identification Produced Type of Identification Produced
Com s ion No.yr (D DAVIDRAYMON PL�Tnlssion NoM .Zia I)DAVIDRAYMOND
rc0r�r NOTARY PUBLIC F.r%j 9zG7 NOTARY PUBLIC
+' r' 19"Z(Q yS TATE OF FLORI A ATE OF FLORI[
Revised 07/15/2014 Expires JJ26/2019 Expires 1/26/201
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS