HomeMy WebLinkAboutBUILDING PERMIT APPLICATION772-770-0064 AR5
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 23 SCANNED Permit Number: I
BY
K ._ St. Lucie County
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 II
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential to
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: I l J•
Legal Description:
63-1 1
Property Tax ID k: I-- "l) — Lot No. f3
Site Plan Name: Block No. _V
Project Name:
Setbacks Front Back: ightSide: Left Side:
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Total Sq. Ft of Construction: _
Cost of Construction: $ C '. LO
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S Ft. of First Floor:
Utilities:0Sewer OSeptic
❑Windows/Doors
❑ Roof
Building Height:
21,
Name
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Ad Iress t
Company: n p
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City. n StatJl-
Zip Code: 1 Fax:
Phone No. Z
Address:z 1
City: State:
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Zip Code Fax: FnO
Phone
E-Mail: t1�LIL/1.t1_
E-Mail:
Fill in fee simple Title Holderan next page I if different
from the Owner listed above)
State or County License 1 QltZi
If value of construction is 52500 of more, a RELORUEU Notice or tommencemem 6 regmreu.
772-770-0064 ARS
- :04 01-23-2015 3/3
I SUPPLEIVIENTAIL GONSTRUCTIONLIEN LAW INFORMAT10Ni'`
DESIGNER/ENGINEER:
_Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
Name:
Address:
Address:
City:
State: _
City:
State: _
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
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
STATE OF FL RIDA n STATE OF FLORI
COUNTY OQ� 4I l 1 COUNTY OF � IS I l t
The ing
thi day
Type
Commission
Revised 07/15/20
.dgerj before me The forgoing lost ment w _ acknowledged before me
20 by thi day 20_j$�by
OR Prdducdd Identification
ELLY M MOHNEY
?F/ EXPIRES June 10, 2018
Persona ly Known _ — OR Prod1
Type oft Ification Produced_
Commission NoF�--
��`2�
My COMMISSION MFF1012o9
EXPIRES Juna 10. 7ma
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REVIEWS
FRONT
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SUPERVISOR
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VEGETATION
SEA TURTL9_
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
JAN/23/2015/FRI 10:00 AM ARS Rescue Rooter FAX No,772-794-979q
P. 003/006
SUPPLEMENTAL CONSTRUCTION LIEN' LAW INFORMATION: IIII
Name:
Address:
City: Stater
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:_
_Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
City:
Zip: Phone:
State:
BONDING COMPANY:
Name:
_Not Applicable
Address:
City:
Zip: _ Phone -
I certify that no work or installation has commenced prlorto 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 SL 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
STATE OF FLORk
COUNTY OF� DA� C 1 Qc COUNTY OF SIPiI te�l. "Oi
The ing
this day
Isill;ffat of Notary
Perso ally nown_
Type I ntifiwtion
Commission No.a
Revised 07/ 15/20
dgerj before me I The forgoing
20 by thi day
OR Prefiuc4d Identification
ELLY M MOHNEY
1�qJ EXPIRES June 10, 8018
Persona ly Kn wn _�_ OR Prodi
Type of I ficaa�tior-n Produced_
Commission No.�'t-' �EA2 `-R
before me
My COMMISSION WFPISIeog
EXPIRES Juna 1n. vnia
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
aorta
VEGETATION
REVIEW
a-0tsa Faridall
to BOrvlCa,tlorn
SEATO
REVIEW
REVIEW
DATE
COMPLETE
INITIALS