HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE /INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Num
BY
St. Lucie County
Building Permit Applicatio
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
/`T_0�- O 0� -
M I
JUN 2 9 2018
Permitting Department
St. Lucie County, FL
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line K. II
Address: C9OO_ S Ckisn Z>cW C_ Uri�f Co03
Legal Description:&_NQ(-CSS CO(Vd.6rn6ni Jr,, Uryt{- GO
Property Tax ID #: (-(5O a "(a 1b -003q --()OC3 -CLot No.
Site Plan Name: Block No.
Project Name: S0cGr Goe) I Mn
Setbacks Front Back: Right Side: Left Side:
cj ,&ems CX2l S/($) M ' ZG CA,, a,
CIHVAC 11 Gas Tank ❑Gas Piping _Shutters
Electric El Plumbing Sprinklers 11 Generator
Total Sq. Ft of Construction: 5 Ft. of First Floor: _
Cost of Construction: $ 1093.9a Utilities:InSewer 0Septic
Name JC JCCn ,pn r. n.,q7
Address: q(,OC) S OCe�nn r•W C,(-)nii GOS
City: 3C-oscd+ (Scat,, State:
Zip Code:34qS 7/; Fax:
Phone No. 3 (S - aq-2 -(off
E-Mail: Sl1S0.r� �SY\nnou@ 11n hrv, _ r n
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
value of construction is $2500 or more, a RECORDED Notice
Name:
ED-W'indows/Doors
0 Roof
Building Height:
Company.U�l
Address: 1 a4 io i `7qT41
City: I. 1w 2c C L, State:-F—C-
ZipCode:3SY I D2 Fax: SQlll SS•�fDS(
Phone No. 44 U5 a
E-Mail:
State or County License: C (o o d c_FS 3 l
Commencement is required.
;Si a-�tlGTION UFN`'LA111/tVFOMATION' isZf,:Asia`2+r".Gx�.��sdrn4,rw^v&4.o.e'�c"�#.:2n?J3'4.�Sn�r+i.�r,
DESIGNER/ENGINEER: 4@$d•�����P�+s��`a2
_ r .
MORTGAGE COMPANY: _ Not Applicable
Name: G Name:
Address: Sv' Address:
City: ,o _ State:_ City: State:
Zip: 3"34-(2 Phone: �q�4-35Lf_ploi"o[ ZIP: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Name: Name: _Not Applicable
Address: Address:
City: City:
ZIP: Phone: Zip: Phone:
I certify that no work or installation has commenced priorto the issuance of a permit.
St.
is In conflict with any applicable )Hothat
e Owners Association) permit
lesabylaws or anti covenants that may restrict oar 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
cornmP_ncinP wnrlr nr rornrrlino „nnr n1,.H.�.. —c r..�_____� __.
CXYI , Qwd Yx D A q`2�42� s
iSignature of. owner/ Lessee/Agkt ature of Contractor/License Holder
STATE OF FLOR Dr�A STATE OF FLO DA
COUNTY OF 1 1 1(i C V1 n COUNTY OF_ G,+ 11,q o&,2
The forgoing instrument was acknowledged before me
this 10clayof 70rn,e— 20lgby
Svc .Csu Amon
Personally Known _
Type of Identification
Commission No.
Revised 07/15/2014
OR Produced Identification
TEPPER
The forgoing instrument was acknowledged pgfore me
this _Zdayof, JC/�jC 20 IT by
(Name of person acknowledg ni g )
(Signatu of Nota Pubil Late of Florida )
Personally Known ✓ OR Produced Identification
Type of Identification Produced
ANGELAYOUNG
Rol
O Isslon No. r ,.n r M)(SealkslONt FF951069
N<o` EXPIRES: Aoril 122020
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
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DATE
COMPLETE
INITIALS