HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SISI1Dr5 SCANNED Permit Number: �W� k.)v��
BY C �j
St. Lucie County CJ�'
Building Permit Application �} �C-
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: To Select from dropbox, click arrow at the end of line
PROPOSED]
Address: .3 10 0 d A fA U A/z 7 60t
Legal Description: &Aan b,Vc-r 6Cfa 0°c %N 6cS4oyac &Aldu)4U.z7 2,z �
Property Tax ID#: %N2S- 606 - go27 - Do0 ` g Lot No.
Site Plan Name:
Project Name: EtEj - +� S4NOJ
Setbacks Front Back: Right Side: Left Side:
Block No.
DETAILED DESCRIPTION OF WORK: q
CONSTRUCTION INFORMATION:
Mona wor to jepe orme un ert ispermit-checka appy:
�0HVAC ] Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
LJ Electric L"J Plumbing Sprinklers Generator g Roof
Total Sq. Ft of Construction: 306 5C- 1 S Ft. of First Floor:
Cost of Construction: $�-p00"• DO utilities. SewerESeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name bo-rlM13 f Loslie rvbr!j
Name: AoOLAs_9 etwo r.9►cLi
Address: 3Lors .4. A rA Gn-t_�ooh-T_ _
-Company:—4hsnlu4e p I �y�
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city: -GoC4 4i tr cc Stater
Zip Code: ?U 3 U I Fax:
Phone No. 'fib S - 3Al - I I US
Address: $a.%s 656 S4ret}.
City: '\/ero 9 e_c l
Zip Code: 3 2 46-i Fax:
Phone No. *7 -
State: Ft
E-Mail: A CIt J SA C4 Q 1 dlseJU • Ae }
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: a bsa I u I'$ b►aal i
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State or County License: C8C.
12 45 27 (4
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I
DESIGN
Name:
City:
Zip:.
Not
State:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
City:
Zip: Phone:
State:
BONDING COMPANY:
Name:
_Not Applicable
Address:
City:
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
STATE OF FLORID STATE OF FLOjj2JD p
COUNTY OF ndAa (I1�/P f COUNTY OF I rIC�
The foFgoing instrument was acknowledged before me
this)dayof McAk✓ � .. 20-by
of person acknowledging )
of
The for ing instrument was acknowledged before me
this __--day of 20_1 by
(Name or person acKnowieaging
(Signature of Notary Public- State of Florida )
Personally Known ✓ OR Produced Identification Personally Known V*�_ OR Produced Identification f `
Type of Identification Produced Type of Identification Produced
Commission No.
EXPIRES January 20,
Revised 07/15/2014
on No.
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
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SEA TURTLE
REVIEW
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MANGROVE
REVIEW
DATE
COMPLETE
INITIALS