HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number:
BY RECEIVED
St. Lucie County
UG 1 )013
Building Permit Applicatio AUG 3 =12013
C u ty,
Planning and Development Services ST. Lucie Cok�ty, aermitting
Building and Code Regulation Division _aermittino
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
PROPOSED IMPROVEMENT LOCATION:
Address: In 221;t0 'S OLF—fif!) _1�)&06
E&C6AJ
Legal Description: kf��,TA-fJjq �_WR, (fjC�ATh6A1tjq
Property Tax ID #: 4r,�_ 1 4-1 — C_Y)rCD 0� — C5 Lot N6._
Site Plan Name: Block No.
ProjectName: bq U49L- C// CLUIS
Setbacks
Back: _ Right Side:
Left Side:
I DETAILED DESCRIPTION OF WORK: I
I CONSTRUCTION INFORMATION: I
HVAC
Tank L_jGas Piping
[JElectric Elp'lumbing []Sprinl
Total Sq. Ft of Construction: '2_ 2_tnr�
Cost of Construction: $ cu�pe>
S - h . utters DWindows/Doors
Generator E] Roof = Roof pitch
S Ft of First Floor:
Utilities'll Sewer Eheptic
Building Height:
OWNERAESSEE:
CONTRACTOR:
NameVt21-"A-
Name: F"P_ 7[PCkW
Address:— C1,80 2, S&19 ghg=CO
Ct--
Company: CC5�'�hf-
City: A f& WA Al -'b State: _St,
Zip Code: 2,zal q Fax:
Phone No.
Address: STP3?, At!W#'24Qr-_ G�7_
city: State:J�_
Zip Code: r;�L4_ 11 Fax:!q��,7 Zt5��-�tI8
Phone No. I - t'- q-?— _' -5j-Z-7.
E-Mail:—
. Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: pj&'e 0 6ULF, C (, i - CS)V
State or County License: C&r- 162-COA'2-
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:_CkaLo6ir 5P Mc�eXAnkmm-n
Not Applicable
anc--
MORTGAGE COMPANY:
Name:
Not Applicable
Address: J2�_ L4C, kaH&rl�Y
Address:
City: — '3_'
P&
Zip: 3�Ljo& Phone.
State:
City:
Zip: _ Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_t,4 Not Applicable
BONDING COMPANY:
Name:
NotApplicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTORAFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or insta I lation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording Vour Notice of Commencement.
Signature of Ow r/ Le !�c �eontractor as Agent for Owne—r
Sig=naturnq$&1f6`r/License Holder
STATE C
5 OF FLORIDA
COUNTYOF
COUNTY OF -S �- �
The forgoing instrument was acknowledgq beforeme
A
Thef r )ing instrument was acknowledqe� before me
'Zk -h
this">\ dayof 20 by
this day of .�!3 20\ by
7y (5 %)-f\ �
<;.,\ \ � 3 6,3 V, \-
Name of person making statement
Name of person making statement
Personally Known _ OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identifi tt
Produced V-
Produced
(Signature of No
ignature of Notary .06 ---- fte 4�FalirpsIr'ON" �lv"Ns
GG 022023
Commission No.
WRES: Dem er 16, 2020 9
U 1.6 B edThrUq9XrJG
mmission No. ZE ond M
Undermile,
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17