HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONle -.'A
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: g IO I �I SCANNED Permit Number:
BY
St. Lucie County EnAUG
EIVED
Building Permit Applicati 0 2 2049
Planning and Development Services
Building and Code Regulation Division ounty, Permitting
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 k,) ', haox,�,S I
IMPROVEMENT
Address:
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f 4R R Block No.
Project Name: '�!Iaison,
Setbacks Front Back: Right Side: Left Side:
DETAILEDDESCRIPTION OF WORK:
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dO-OrS• hcLs shV "-erS .
CONSTRUCTION INFORMATION:
AClaitional work to
0HVAC
orme under t—checkispermit
OGasTank E]GasPiping
a
appy:
LAShutters
Windows/Doors
Electric
0 Plumbing
Sprinklers
Generator'
Roof Roof pitch
Total Sq. Ft of Construction:
S Ft. of First Floor:
Cost of Construction:$
IoII000 Utilities:
Sewer
ElSeptic'
Building Height:
OWNER/LESSEE:
'CONTRACTOR: , '
Name n
Name: �i Gi LQPro
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Address; Clot S S. cx%e r) bywc tnQiB
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Campjhe: Q=ti�is �rQ ��� i onalo
City ))IPt1gPXl.r,BPQC?I1 +: State:;±Z
Zip } ode
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Address ,—__ :SI✓?;D06C -t wjtij
City �511'1L��p �i, t: t : ` State: F.
-Zip Code:3`WIQ7 ` �- Fax: ltid 1$lo'o�Ibl
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Phone No.
E-Mail:x(�)7V Y1 , ► fS(1)1%%YY� lJ • CYiCi1
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:
1
4
State or County License:
If value of construction is $2500 or more, a RECORDED Notice. of Commencement is required.
J" i
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
as
STATE OF FLORICNoLN n COUNTY OF
STATE OF FLORI�A. rb n
COUNTY OF �/ ��e
The ing instrument was acknowledged before me The for oing ins
thisor odayof 20]_$by thisdayof
1
Personally Known V OR Produced Identification
Type of Identification Produced-7
Commission No `I (Seal)
Revised 07/15/2014
Fennt�w�a5y,acKnowledged Detore me
U f , 20 f&by
aprac1lai
acknowledging)
of Notary Public Rate of
Personally Known \/ OR Produced Identification
Type of Identification Produced j
Commission NoC 15 1 I (Seal)
EXPIRES: January 24, 2022
Bonded 7Mu Notary Public Undewritals
Bonded Tide
24,2022
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