HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number:
BY
St. Lucie County
---' ---' ----__ RECEIVED
Building Permit Application
Planning and Development Services NOV 0 8 Z018 `
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ST. Lucie Gotinty, Pgrmlttl
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR To Select from dropbox, click arrow at the end of line
PRQPQSED'IMPRO�UE11`%IE;NT,LO;CATIO�N
Address:
Legal Description: � Z� S �CJr•C�(i { n C1 U r� Q U f1` iQ(�
Property Tax ID #: 3535 - 700- -M5.3 -Qs06 -3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Total Sq. Ft of Construction: 5 FtFt.I of First Floor:
Cost of Construction: $ l3�{ l' 3� Utilities: LJSewer Septic Building Height:
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Name SINKCk
Addre`ss:c9�10Q 5 0ew. a ty t : )nc% 70( S Company: J�C,� C1C1 r a]F ry �i (V L
City: � nS 'e-% &-ac], State: Address: I .4 Q 1 —7 T
Zip Code: AC{Q 57 Fax: City: I.L , 1vti Rec-, c. k State:�L
Phone No., 1�ko(w Zip Code:-3SLl 1 3-- Fax: `J-LI . �SSS`• e1V
E-Mail: Phone No. 5-L.,/- OS a
Fill in fee simple Title Holder on next page (if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
��1PN1ALitONSbRJGTI'ONLIEN LAW INFO _ G.
....r,.�MAT�ONrhf}
DESIGNER/ENGINEER. '..,_x'a� 4c' a',�``F
Not Applicable
MORTGAGE COMPANY: Name: Not Applicable
Address: Name:
City: Address:
ZIP: Phone: State: City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable BONDING COMPANY: Name:
Not Applicable
Address: Name:
City: Address:
Zip: Phone: City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.
is In conflict with any applicable Home aOwners Asssociati nl rulesabylaws or andpcovenantsthat may resthe
trict 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 recordine vnur Nntlre f
STATE OF FLORI STATE OF FLOfDA
COUNTY OF—_�� COUNTY OF VCAA L e�
The fpp``goIng instr ent was acknowlecig���efore me
this ` clayof,�_, 20u,b by
1
(Name of person acknowledging)
Personally Known OR Pr2IJVced Identification V
Type of Identification Produced I (,�Y(_ Q�2Commission N ,rM '`�'� CoCoril�itW. nfiGG027899
Expires December 13, 2020
Revised 07/15/2014
The forgoing instrument was a knowledged before me
this `7 day of I��C�VPtxJQ 1 20
person
ANGELA
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41ES.ao..V h'FF 951069
laignaturVt Notary Publig- State of Flbrid"z1'7'N04sys, ,,
Personally Known -.1Z OR Produced Identification
I
pe of Identification Produced
mmission No. _ ryV F E;' ANGELFIVu��
EXPIRES: Apth 12,2320
REVIEWS
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VEGETATION
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COUNTER
REVIEW
REVIEW
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REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
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