HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I II
Date: i SCANNED Permit Number:
BY
a St Lucie County
Building Permit Application RECEIVED
Planning and Development Services. _ Nov 13 1010
Building and Code Regulation Division •-
2300Virginia Avenue, Fort Pierce FL 34982 Permitting Department
Phone: (772) 462-1553 Fax: (772) 462-1S78 Commercial V// Residentialft' "—Ioe county
PERMIT APPLICATION FQR: To Select from dropbox, click arrow at the end of line
Legal Description:
-Property Tax [Oq: L5'JQ 3;1- 0t)oI-020 =1 LotN6.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
60'AmAt- � ba.Qc-chics ?Die at\J S08 -
CIWAC ❑Gas Tank []Gas Piping UShutters
Electric 11 Plumbing ❑Sprinl
Total sq. Ft of Construction:
_Cost of Construction.S -i ACIJa
:rs LJ Generator
Ft. of First��F"ll"oor. _
Utilities Sewer L Septic
Name:
Windows/Doors
aRoof ,= Roof pitch
Building Height;
• State:rLL Address: t`1%56 bil 3111M icoe^t ory1 w�i
2ip'Code: ZAFax: City: lMwt State:�L
Phone No.t`-t— 14--10 zip code: &33�4 Fax: gS4-(ao-j-S',2O
E-Mail:��4SA. Phone No. 4S4-581-Longh
Fill in fee simple Title Holder on next page (H different E-Mail;
from the owner listed above) State or County License: s
..._.___. �_�_.y=_.. eeM.........o .asevmnen Native 01 Commencements required. _
c
� SI�PPEEt�ENTAL CQNSTEtUCTION LIEN. LAW' INFORMATIQN ria
.Name:�iOc&'yrtni AtiSc•iol+S' V
Address: zcc' N rtir u R 1 Syr lot
City: Cttd-yr tour State:rL
Zip: 2--1„Ll Phone 5-31_- g1-11
FEE SIMPLE TITLE HOLDER: _ NotApplicable
Name:
Address:
city.
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name; NIC
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name: NIW
Address:
City:
Zip; Phone:
........y —ni s n ui wnl+rrisovi s: Appacation is nereby mace to obtain.a permit to do the work and installation as indicated.
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 ermit holder to build the subject structure
which is In conflict with any applicable Home Owners Association rules, bylaws or andpcovenants that may restrict or prohibit such
structure. Please consultwith. 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.
Thefollowing building permit applications are exempt From undergoinga 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
commencine work or recordine vour Notice of Commencement.
Signature of Owned lessee/Contractor as Agent for Owners
Signature of ntractor/Ucense Holder
STATE OF FLORIDA
STATE OF FLORIDA
OF
COUNTY OF To -Linn
COUNTY
The for oing Instrument wasac nowledged before me
The forgoing instrument was acknowledged before me
q dayof NJVeiMbty -
this_n'day of %i0d2C1rt 20j_bby
this .2010-by
%i0.y-k .l�'a-lS�'l
Sce+F Jt,�tkivt r V P-
Name of person making statement
Personally Known_ OR Produced Identification _
Name of person making statement
Personally Known OR Produced Identification
Type of Identification
Type of ldentificvQtion
_
P duced
Produced t.11iL
�Oyyt_ •"'.rr KRISTINA ROMAN
(g 'r+rmcdrejadr
Si nature of NoWNOTARYPU%IC
Signat re of Notary $leoc rcc ltr7a6
?ava' My Comm. Expires Oct7.2012,Commission
No.TE Od RIDA
Commission No. "` Bonded Nmugh>(9ea1) Notary Assn,n
WGG015495
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Rev.8/2/17