HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFOfAUST BE COMPLEI . �:011 APPLICATION TO BE ACCEPTED
Date: SCANNED PermitNumber:
BY
WIN NMI St. Lucie County [RECEIVED
Building Permit Application S P Zo
Planning and Development Services SEP 2 1 Z018
Building and Code Regulation Division T Lu Co
ST. Lude County, Perrilittin5.
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 - v�
I C-qz AO III
0:4 fto] 0M ;1110.11 LVA 1:1 lhfelyj :I LVJ 140 1 a Mil
Address:
RN
Leg@] Description: AfkW[/S 1/1 'BY I)Ibff-W.2
Property Tax ID #: -Y511-5_J,9-b63Q WO-6 Lot No.
Site Plan Name: IF—,SUF_ FA:S(_#&E Block No.
ProjectName: ZF,,5PE ?ASCAL6
Setbacks Front Back: _ Right Side: Left Side:.
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Additional worK to ne nerformed under
ffi—is
all
prial apply:
FV1
HVAC Gas Tank
ElGas
Piping
Shutters
Windows/Doors
Electric Plumbing
OSprinklers
n—Generator
Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 11460. b6
S Ft of First Floor:
UtilitiesIn Sewer[] —
— Septic
Building Height:
1j.
Name Jek)e ?#Wk"Le
Name:
Address: /0.2 -5 �jCRAJ I)fJVF—
Company: ERS7M67RK c2K77i5L_&*
city: J3_6ABW 261M StateA
Zip Code: 3yq57 Fax� b'a �' -9�77_ —Z'6? 13—
Phone No.co 5;, ZZ500 -ego-g-C-)
Address: 1,2Q.96 SE C_,0Z41UAJc� b9-
city: 1-4613—C Wwb — State: /�L
Zip Code: (330- Fax:7722232q7
Phone No.W 3M 6
E-Mail: /> egAy l&,g1dR
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: rlFe:tl�-OM"ki-daf-eS)Lulf(A-ebrO
State or County License:
It value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
Name:
Addre!
City:
Zip: —
Phone:
State
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: —
e:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: —Not Applicable
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Coun makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conlylict 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 oVecordinR vour Notice of Commencewent.
— Sigt�afbr6-cif Vner/ Lessee/Agent
STATE OF ELeR=Aeuj-
COUNTYOF
The forgoing instrument was acknowledged before me
this of 20 L2 by
ii6qgyi�618M NWOISMVY�MM
'19C�w AN
Z 01
LKU ai
Amer MON 10 91% lollqnd keloN
(Name of pW1NMIdv-&0MVHS
(Signature of Notary Public- Stite of ffofida
Personally Known �'� OR Produced Identification
Type of Identification Produced
Commission No. (Seal)
Revised 07/15/2014
STATE OF FLORI
COUNTYOF
The forgoing instrument was acknowledged before me
this_Z—t dayof 5,c,74 20 JFby
I
Ak,__ z_&,A-eA'
(Name of person acknowledging)
JENNIFER MARTINEZ
My COMMISSION #FF902867
(Signatu Notary Public- S rt:b L L
roU�11U
rNW%?orn'fle St st = nee
Persona Known OR Produced Identification
Type of Identification Produced
Commission No. (Seal)
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