HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMP'L'.:'3D FOR APPLICATION TO BE ACCEPTED
Date: // Y6 ,2ol8 SCANNPee® it Number. I�R a -00,03
BY RECEIVED
St. Lucie county
DEC 11 1018
-I Building Permit Application, Permitting Department
St. Lucie County
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 Residential
PERMIT APPLICATION FOR..-M ^R/Um 0" Tl/fa o6&Y w YT Lawoo�*Ni z1m ftsv'cUiA73a
Address: 3006 +S'141,4 T-toper %7 i b72CE� oc7l- 3 r/fr'e
Legal Description: 1 h, 44-ri t m c r. `iiN�- cp�v�. I I - Ar ci2 r2dO m in Jum
StioLo ire or 1668-b9`/- C q.4), A -el ISM,
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
Block No.
ES7b>LvYi2 oar/ o V LQ Ln6/2.S ne- uD " O CK
3ALcv-n,y �.OaIC/Lb'7Z' /L �'
6 F C6W>Jam ,.Jiva•n RUlt.d ItiG
_Mechanical _Gas Tank _Gas Piping _Shutters —.Windows/Doors
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 4 Z
City:
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
iG�a'M1� •• vi„ a
• FT=��c�zc�F�' a YS4
zip code: Fax:
Phone No. 77a- R JF-5-- 3.5 57
E-Mail:, 114<16:z /g7 Cr044 Q.0'Aet't-
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
City: 04. ecL/06l? State:�J�
Zip Code: _?y423 Fax:
Phone No � %+A
E-Mail S:?yer-emeary DL.Ca I
State or County License C6G 60WV 33
If value of construction is 2500 or more, a RECORDED Notice of Commencement is requirea.
Ffl
5.0 P TXt N TR • N LEN L A
DESIGNER/ENGINEER: _ Not Applicable
Name: kEi'STaNC re1Aj&z3Yt1cK -Sam 9n,oay
MORTGAGE COMPANY: Not Applicable
Name:
Address: 4!L�W7&y2 ST .rcv;Tz.= e2ta
Address:
City: CA-°6 vz_ )Z M State: r/—
Zip: Phone 3� / - yS S�- 7_7vU
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY: _XNot Applicable
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 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
commencing work or recopding your Notice of Commencement.
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Si&ide of Owner/ Lessee/Cort4ctor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA n
COUNTY OF lQ
STATE OF FLORIDA
COUNTY OF ST Ldcio
The forgoing instr ent was acknowledged before me
thisdayofp�/,�20�Ja'ak j�
The forgoing instrument was acknowledged before me
this 6 dayof dew 20_/Sby
�1fbYV1.P.�J D�NLIA/P / U:(f/lY�1L1, jjt .
Naro of person making statement.
Name of person making statement.
Personally Known OR Produced Identification X
Personally Known --le-1 OR Produced Identification
Type of Identification
Produced ,\ S U c .
Type of Identification
Produced
,0 z7x avet,
(Signature o -
r" DEBRALACM
Commission Y02i3
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