HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
ALL APPLICABLE INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCABNNED Permit Number: $arD v 033a
�� . ---- St. Lucie County RECEIVED
Building Permit Applicati n JUN 18 2018
Planning and Development services ST. Lucie CtlUW, P&Hitting
Building and Code Regulation Division "
2300 Virginia Avenue, Fort Pierce FL 34982 /r
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential \J�
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED I M 0 KOV E M E__N_ T L'OCATION't
Address:0 �, 6eC-V*n/Dr, Jt7VSew d%r,14 ISOci
Legal Description:_ =%1%AyyJ A_ Tr
Property Tax ID #: - r{i0 2 -L d 2-o/s/3-Qoa-f Lot No.
Site Plan Name: Block No.
Project Name: W4 k-,tpq: `A &to
Setbacks Front Back: Right Side: Left Side:
:DETAILED DESCRIPTION°''OF WORK
�%r5'i-A- l l C� 1�- Jw�T w JUvcQeu� orw.�Q Cif zft y
CONSTRUCTION INFORMATION;
L IHVAC U Gas Tank []Gas
Electric 0 Plumbing ❑Spr
Total Sq. Ft of Construction:
Cost of Construction: $ 4TPt)
Piping
ers L J Generator
S Ft. of First Floor: _
Utilities:Sewer OSeptic
Windows/Doors
Li Roof = Roof pitch
Building Height:
OWNER/LESSEE
__ ..._ c_ _ .
CONTRACTOR:
Name_ 0o9"//P!P-AJ 2'�We^f it
Address: 9S�a 5,i0e r �l .' tio9
Name: Vdzh o VA - I t 5
Company: ;kO* �.6YtSfToc'(7aN Ll�
City: goysoy�t4 State:Fl
Zip Code: I'%9f L Fax: —
Phone No.
Address: 111ou tw. e-ka(�vrvllG..,17i
City: (-G:taHa)tkee State;
Zip Code: !J Fax:
Phone No. YL I - G f. O _3 3p I/
E-Mail:
Fill in fee simple Title Holder an next page (if different
from the Owner listed above)
E-Mail: of frNa:/.
State or County License: C ('s 4E /tL /C7 L/
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
4
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION;,
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone:
State: _
City:
Zips- Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY-
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
au ucwre. ricase wnsmc wan your nomevwners.Association ano review your aeeo rorany restrictions wmcn may appry.
In consideration of the granting of this requested permit, I do_hereby.agreethat I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codesand 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
n
ylgnature or owner/Lessee/Lontractor as Agent for Owner lgnature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S+, is i L' COUNTY OF S-I . L ✓C i; r e
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this-7-dayof_20I by this , -day of !:; L - 20/�' by
k[144. byrr✓t-F- _ y9►a wt 6ls
(Name of pgmTnZick wledging) ' (Name of er acknowledging )
(Si tar urebf'Noy�(W6 State of Florida) (rture oWotary Wic1State of Florida )
ersdnallyKnown OR Produced Identification Personally Known IL//R Produced Identification _
Type of Identification Produced -C. to 7- Type of Identification Produced
Commissi ryPbai F4" -, STEPHEN S JyTON Commission N .. :��%t•.
1' MY COMMISSION#FF770384 �a° A STCPHEAF&L.TON
y g; MY COMMISSION #FF170384
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