HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST gE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number:
-,y BY
• St. Lucie County
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
'I f
MAR 12 2019
ST. Lucie
Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address:C{�t„�.me ft e iC� C9urt _
Legal Description: C-l.e. Gc-e e Cncb,- r%C i t-,'vr+�
Property Tax ID #: 3Lc l0 - SL7 -C1a0-nar1-7
Site Plan Name:
Project* Name:
Setbacks Front Back:
Cb&Nse, oA doa
❑HVAC ❑ Gas Tank
Electric In Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ D5Z5_Z .: C%
Right Side: Left Side:
r10 3 a Z C. CGCn19c..
Lot No.
Block No.
Piping UShutters Windows/pQ=
nklers I Generator 0 Roof
S Ft. of First Floor: _
Utilities:Sewer ESeptic
Building Height:
OWNERf
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LESSER:�i� ,''+� #;FK at x
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Name n 10rcQ SCk.n 1 r/�� t
Address:5$L(4 SUrnrrCX. loi Corict
Company: 1.1 C, OCto
City: E± Prc.re f� State: El
Zip Code:34 C'r 1?a Fax:
Phone No. a34 -01 P -a(,L(3
Address: i '� 4 Q 1 `75 74-1 ' 011F 6,
City: 10 , r` kn1 : 2,ie C-, Q 1-,, State:-F—'--
Zip Code: )sLl 1 Q-_ Fax: 5 -1 . `35J • �fL `i
Phone No.5-(,!1 c�-.5"S- C,S-
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:
State or County License: 0<7 l 3 1-
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
I Lf. *1(aq
SUFLE(VjE T.�,'LR4T]STtU( fl(fV iI�N LAWuINFOR_hA1�ilONn's
DESIGNER/ENGINEER.
.v..3 �
€�r
_ Not Applicable
MORTGAGE COMPANY.
Not Applicable
Name:
Name:
_
Address:
Address:
City:
State:
City:
State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
Applicable
Name:
Name:
_Not
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or ahcicovenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
S
S_ igture-a£-Owher% Les_ se%, Agen dl$ ature�ctor/License Holder
STACOUTE OF NTYOFORIDA r _yi,n COUNTYOFSTATE OF O(/�ILn �pGGYI
The f ing instru nt w acknowledg efore me
this day of 120by
person
The forgoing instrument was acknowledged before me
thislLdayof MLA✓: ,20by
Jam s s
(Name of person acknowledging
ighature pf:N t ry Public;�Staterof F.16 iO5�.r (Signat� of Notara/
Personally Known OR Pr" Identification Personally Known _
Type of Identificaatiioonn�Produced
� t-!l� Type of Identification
Commission No.lQ 1✓✓lY' a Wmmission No.
Revised 07/15/2014
i • MY ExpYN
4 QormI I N0.:i84M
of Florida )
OR Produced Identification
ANG&OING
MY COMKIISSION £ FF 951069
Son0o91Ttu Suogoi Notary SeMce
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS