HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONM
Date: �,Z)o - J Permit N r.--- L-6 U7, 0
SCANNED
BY RE
St. Lucie County ED
Building Permit Applicat on SEP 2 4 2018
Planning and Development Services
Building and Code Regulation Division Permittir)g D8Partment
2300 Virginia Avenue, Fort Pierce FL 34982 St. LUcie CountY,
FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial V/ es
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line irl
To -
Address: Fv-grp/ g-fRcer
Legal Description: WA(I c/ rY 1510 o3 6 Yo /- e7rR,;? _s c,11W4 Rlw—
A I-Or5 5-9wh W
Alp — /I
P rope y Ta :�W03 Lot No.
Site Plan Name: -Block No.
Project Name:
Setbacks Front Back:_ Right Side:_ Left Side:
Rr,Pt&'91q15A17- OF &V71 0 0C)f S
FX� Windows
4Q!
E]Roof
Total Sq. Ft of Construction: 5 Ft ofFlrstFloor:
Cost of Construction: $ 76? Utilities:11 SewerE]Septic Building Height:
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F. )R;.
Name: �E, f(Y( 01)
Nam n!C&L-
Address: 0?81 7ROF16/k
Company: A6)VN-YA1t1 Gz91M4(-70-)&
City: lc:--CKr PIARrE- State: /4Z
Address: 11;9-119E
zip Code: 2�k?8'2 Fax: 44`�9-4/979'
City: 46M2# Sta
Phone No. 19'19,�,F
Zip Code: Fax: 0'72p�.q
ml
C4yhonel%lo.
7'16� —5-6 3 -- CD 70!2
Fill in fee simple Title Holder on next page (if different
E-Mail: ON 7 � �7 - �,I) SO
from the Owner listed above)
State or County License: CGG 05-75-;76
-if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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Name:
City: IWL.121civ State: P/_
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Zip: e:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phon�e:
COMPANY: — Not Applicable
Address:
City: State:
Zip: Phone:
BONDING
Name: —
Address:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
—Not Applicable
St. Lucie Court makes no representation that isgranting a pennitwill a . uthorize the permit holderto build the subject structure
which is in co2lictwith anyapplicable Home Owners Association rules, bylaws orand covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and reviewyour deed for any restrictions which may apply.
In consideration of the granting of thi's 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
WARNI NG 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 Your Notice of Commencement. ,
_J!k4Mreof Owner/ Lessee/Agent
STATE OF FLC&ft,6
COUNTY OF
The forgoing instr t knowledged before me
2
J5 _wnentwas aq
th is day of Z�-e V:faywr 20 12 by
STATE OF FLORIDA
COUNTYOF
The forgo' !ng instrument was acknowledged before me
thislVda'yof giEEPOlq 0 /?by
bpfk+ vmv�ca &2&5kr r.F. H'I (f KEA5-OAI-
of person acknowledging) (Nami5 of person acknowledging)
&264 --zq7—
J0lkPffio4lry.PdblIc;,State of Florida) (Signature of Notary Public- State of Florida )
Personally Known V OR Produced Identification Personally Known "� OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. Commission No. (Seal)
WCOWIS
CHUAHUMPHREY-
BRIGITTE MH
State of Florida
Notary Public
1. 4 ..'.0 � . I.. e.
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P
14., i022
my Comm. Expires S,
Revised 07/15/201 . .......... Bice ded through National Notary Assn.. EXPIRES:
REVIEWS
FRONT
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SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
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