HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLIC BLE INFO MU T BE COMPLETED FOR APPLICATION TO BE
ACCEPTED
Date: I I
1 l 14 Permit Number:
RECEIVED
Building P�'t&Pplication
Planning
AUG 01 2018
and Development Services
Building and Code Regulation Division BY
2300Virginia Avenue, Fortplerce FL34982 St•WdeCoun
T. Lucie County, Permittin-
Phone: (772) 462-1553 Fax: (772) 462.1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click here
PROP•,OSEDAN"RR®UE'IVIENThLOCAYI100,N 4 1i �f axe "p :`
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Address:
Legal DesFriptio : I (f
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Property Tax ID #: — — 6
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Site Plan Name:
Lot No.
Block No,
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED,DESCft1PTI0N'QFWORK]�',
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CO__NSTR@1CTION�IIVFOR,MAT1®N
to or to e e orme un er is perm
111.11 all Pp Y
HVAC Gas Tank :]Gas
Piping Shutters
Q Windows/Doors
Electric 0 Plumbing ❑Sprinklers
Generator
Roof
Total Sq. Ft of Construction::
S Ft. of First Floor:
Cost of Construction: $n;ao I ��% Utilities: OSewerSeptic
Building Height:
OWNER%LESSEE }t 'C0NTftYgCTOR
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Name`.�
, Name:
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Add r ss• om-apy: If n
City:
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Q
Stat . is v0rTn 0
Zip Code: ax: City:
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Stater
Phone No, -
Zip Code
.
E-Mail: Phone No..
Fax:
Fill in fee simple Title Holder on next page (if different -Mail: nly)c
from the Owner listed above)
f State or County License:
If value of Construction is $2500 or more, a RECORDED N of Commenceme t is requ d.
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DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone:
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
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.
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
accessory structures, swi mfng pools, fences, walls, signs, screen rooms and
WARNING TOO ER: Your fiailure to Record a Notice of Comm�+f
imp ents to your prope)'ty. A Notice of Commencement (ni
b ore th first in pection. If you intend to obtain financing, c
c , mfnencl a wor or recordne vour Notice of Commencement.
Lessee
STATE OF FLORIDA �;
COUNTY OF
The rggIng instrument was acknowledged before meS this t day of `\, ill . 20 tby
Dot4 •A (
cY view: ro additions,
uses to anothe non-residential use
rent may result In y ur paying twice for
be recorded and osted on the jobsite
: with lender or attorney before
of
STATE OF FLORIDA
COUNTY OF
The forging instrument was acknowledged before me
thiday of J_l1, s rl - — , 20 i 8by
(Name
tic», t—A I fF-A7, S P Fl
(Signature of Notary Publi ate of Florida ) Wgnature of Notary Public- S to of Florida )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. FFq`-1SIer4- ., (Seal)
Revised 07/01, y. ,Commission # FF945187
ices: November 19, 2019
Commission No. JFF—a 51g'+, Seal)
eomm(ssion # FF945187
Expires: November 19, 2019
Bonded
thcu Aaron
Mary
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