HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED i!. R APPLICATION TO BE ACCEPTED
Date:Permit Number:
SCANNEDBY REc
® St. Lucie County APR 17
- Building Permit Application tote
Planning and Development Services Permitting Department
Building and Code Regulation Division #t ku¢ie County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR:
Address: /"[.'ll'70 U<Lti«V�ci: e, t<V tI r/6BCC,%!m 7iC4cl&/`J
Legal Description: 104.711 � �� SeC i �Qc+'►h"CTr
Property Tax ID #: _L32 f 6-0 I '60z-k —090— -7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
worx to oe pe
permit - cnec
_Mechanical _Gas Tank _Gas Piping _Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: 32-(A' '
Cost of Construction: $ q6w, e
Sq. Ft. of First Floor:
Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
NERR/ ESSEE:
CONTRr CTOR;
Na I me"o
Name: >'' JV - i t IN, iI
Com an'""' i�fJ'%G
P Y,
City: JU& e1%=!'"'_-;`,`.`'=j Stateya
Zip Code: .3L/qqFax:
Phone No. Z Z -5731
Ad-.---.�'ly
City: �LL�-� State:��
Zip Code: -3( rlFax:
`7'r
Phone o .� - 37
E-Mail: aWlP, . �O I/1F7i 11y4�1� cCO+^�l
Fill in fee simple Title Holder on next page (if different
from the Owner listed above) b
E-Mail
State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
S'UPP EME'NTAL CONST
CTION ILIEN LAUV INDOR
ATI®
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:, _ Not Applicable
Tame:
Address:.-.-.,
' " ".
Address:
City:
Zip: --Phone
State: /t .'
is
City:,- State:
-zip:tPhone:
FEE SIMPLE TITLE HOLDER:
Name: "`
_ Not Applicable
BONDING COMPANY: _Not 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, scfeen ro'oms'anclaccessory 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.
Signature of Contractor/License Holder
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA tl
COUNTY OF 4�• L_u cU-Q-
COUNTY OF - lyGt •2-
The for oing instrumennt was acknowledg d efore me
this �dayof l,�rL ( 20C.0 by
The fo oing instrunlent�rr�b was pcknowledgecjJjefore me
thismdayof IVII, 20/l�/ by
(Name of person acknoppwllednnging)
(Name of person acknowledging)
fi Cc1Lt �11 k5z:5- noW
(Signature of Notary Public- State of Flori )
(Signature of Notary Public- State of Florida )
Personally Know OR Produced Identification
Personally Know OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
�Sr"c•. .1 YN G DRAWDY,
�IS�SOtil)r
`sue • • coni��}}ISS''IOII11N p FF195558
Wm�&
Commission No. v Ff198559
Commission No. Rry t/, 2019le
EXPIRE8 February 11. 2019
�" co'
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW �. ', :,
REVIEW
REVIEW
DATE
_
RECEIVED
DATE
COMPLETED
ev.