HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _;�' 5-r,. 9 SCANNED Permit Number:
BY
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St. Lucie County RECEIVED
Building Permit Application FEB 2
Planning and Development services 2018
Building and Code Regulation Division permitting De a
2300 Virginia Avenue, Fort Pierce FL 34982 St Lucie Countyent
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address:
Legal Description:
Property Tax ID i
Site Plan Name:
Project Name:
Setbacks Front Back:
, Iklt IZ-A-Eik I
Right Side: Left Side:
13N
Lot No. J
Block No._
DETAILED DESCRIPTION OF WORK:'
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CONSTRUCTION INFORMATION:
ttlona work to e e orme under tis permit —c e a appy:
E1HVAC Gas Tank []Gas Piping _Shutters Windows/Doors
1-1 Electric 0 Plumbing Sprinklers ElGenerator E]Roof
Total Sq. Ft of Construction: g� S Ft. of First Floor:
7—do
Cost of Construction: $ 62,3115 Utilities,- _ Sewer E]Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name:
Address: -1503
Company: J( , •. u
City: tlJlK lWR, State: i
Zip Code: 30S'IIr� Fax:-i`l�' l�lU -3131
Phone No. J� �.'Al¢IAILII OC -M, .52- IZ54
Address: J/ 7
City: foa cRCL State: FL
Zip Code: YVfj 9 Fax:
Phone No.
E-Mail: rn1Iii&C P. U,"00.PA11'I
Fill in fee simple Title 61der on next page (if different
from the Owner listed above)
E-Mail: 15hJGFIOAI'kjd et ✓4/.n o - C®,mot
State or County License: (cam its SS3Z
if value of construction is $2500 or more, a RECORDED Notice
is requires.
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I' SUPPLEMENTAL CONSTRUCIFION LIEN'LAW INFORMATION;
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable I BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
Name: _
Address:
Zip: Phone:
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 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.
_A eXZ
—Signature of Owner/ Lessee/Agent
STATE OF FLORIDA 5(I `, k' STATE 0 OUNTY F RIDA S� COUNTY OF LLII. Wlw`�
The forgoing instrument was acknowledged before me
this lk day of i�- 20 I -by
WcWZ1 f, Boy[e'
(Name of person acknowledgin )
(Signature of Not Pu/tiliyState of Florida)
Personally Known V OR Produced Identification
Type of Idepti#•iutitA•.PKdbella— a
Notary Public - StAt rift
om Ion ♦ CIi 01 39
My Comm. Etplrn Avg 21. 2021
The forgoing instrument was acknowledged before me
this yofP? ii 20 —L$y
oc�GKsq)
(Name of person acknowleilging )
(Signature o"otary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
Commission 8 GG
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS