HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO` MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �'afo 41� SCANNED Permit Number: ) �� - a�aa
BY RECEIVED
St. Lucie County
40
Building Permit Applicati n JUL 2 6 2018
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Y Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line ad_
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Address:37)o PJenuer
Legal Description: CTAcd er" CLk i io c MS
Property Tax ID #: Or qOL4 -Ge12-019 R-Ooo-a Lot No.
Site Plan Name: Block No.
Project Name: 1j Z,rkeAe, P �7Sh n
Setbacks Front Back: Right Side: Left Side:
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Andrtiona wor to e e orme under is permit -checkall apply:
1jHVAC 11 Gas Tank ❑Gas Piping _ Shutters windows/Doors
11 Electric EnPlumbing Sprinklers Generator Roof `—
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ L{ �. Utilities:Sewer O Septic Building Height:
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Name oAke&-s+ -04-Icf +,r, Car
Name: ',-VZtM et, J u�
Address: 3 700 (-1J a nve, F
Company--,—F4-(o QCa
City: 1 i . P �CcG e. State:
Address: 1 .2, LF Ln 1 -TS Tt-I 03- ;J
Zip Code:3 L( 1 Lt 7 Fax:
City: W . C J-" —State
Phone No. 7W-Lf(,('�3B3
Zip Code:SSL1I QC-- Fax: M(el. S•�fDS
E-Mail:
Phone No. 5b/ D .SS• !�l U5-a
Fill in fee simple Title Holder on next page (if different
E-Mail:
from the Owner listed above)
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State or County License: C ('n l" - D 'YR 31
If value of construction is $2500 or more, a RECORDED Notice of commencement is required.
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DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Countty� makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in co %ct 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
COSTATE OF FIL
OSTATE OF
UNTYOFS) t Luc, E� COUNTYOFO )/GilM 5G�
CI�2
The forgoing instrument was acknowledge before me The forgoing instrument was acknowledge before me
this day of i _Za /\ 0 _ 20 Wby this Z day of U/ fl ( 20 Lr by
'Yh ; clN e j t o Leri e S 0ID-2, 14 " S
(Name of person acknowledging) (Name of person acknowledging)
(Signature of.Notary Public- State of Florida) (Signatur of Nota ublic- Stat f Florida )
Personally Known OR Produced Identification Personally Known - OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. mission No. (Seal)
p .: "••, AWN A. HAN2' ANGELAYOUNG
° Commission # FF 2263 6 MY COMMISSION#FF951069
y ommiss N , ^' aT EXPIRES: Apd112.2020
Revised07/15/2014 ''•°, „Yo° July Z%. 20t9 9rFore°p Bonded thmBudget Notary SerAces
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