HomeMy WebLinkAboutBUILDING PERMIT APPLICATION----------------
CATI'Oj TO BE ACCEPTED ALL APPLICABLE INFO MUST BE CFMPLAAENt�pi
Date: -,-IN 8 2019 Permit Number:
M
LsT. Lucie County,
Building Permit Application
SCANNED
Planning and Development Services
BY
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie C unty
Phone: (772) 462-1553 Fax: (772) 462-1578 Commerciap- Residential
MIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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PRO
Address: Q Ittto- C4-.
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Legal Description: z /0 W
3SE. 05"K 6V7 &,_, 15'100 fr .6.3 4CI 6L 3-3-3-1 ' 21-1-0
Property Tax ID oj- 312,-006'q - 0 10 Lot No.
Site Plan Name: cln__�Iwvl rC4_-P_ Block No.
Project Name: �2
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTIQN OF WORK
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INFORMATION"'nnalworKTUDe
HTROITTIQ1\1
bilunneci undertispermit-CneLK d1l appy:
rIGasTank DGas E]Windows/Doors
OV 1 Shutters
OSprinklers E]Generator ORoof Roof
pitch
0 Electric Q Plumbing
Total Sq. Ft of Construction: S Ft of First Floor:
Septic Building Height:
Cost of Construction:$ Utilities_T] Sevver[]
OWNER/LESSEE :-
Name., ffiron; 19r. 6(436
Name, Michael Alderman
Company: Veterans Fence Contractors Inc
Address: )o7, o UT&4rn C-+- —
Addr6ss: 2100 SW Conant Avenue
City: C* Cip ft e —State: r-L,
City: Port St Lucie State: FL
Zip Code: 3�9q'( Fax:
Phone No.Zip
Code: 34953 Fax; 772-879-1009
Phone No. 772-678-2358
E-Mail:
Fill in fee simple Title Holder on next page (if different
E-Mail: eddie.aiderman@yahoo.com
State or County License: CBC-045563
from the Owner listed above)
I
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPL'EIVIENTAL
71
CONSTRUCTION LIEN LAW INFORIVlAT10N `3 L f 1
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address: 1
I A
City: —�T State:
City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name: �1 n
Name:
AA 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 Counttyy 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 an9covenants 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
cormilencing wok or recording our Notice of Commencement.
N
At
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Signature fOwner/Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIQA I
U%./ e
STATE OF FLORIDA
COUNTY OF Sf G f c
COUNTY OF G I
The forgoing instru nt was acknowledged before me
this�day(of aby
The forgoing instru�e t was acknowledged before me
this�dayof �2d6�4 2011 by
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jXer
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(Name oof�f//p/nJJ�erso� n%ack1nowledging)
(Name] o�f acknowledging)
'✓�C kiCX
/pe�rson
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(Sigtiatureof Notary Public- Mate of Florida )
(Signature ofNot Public- State of Florida)
Personally Known OR Produced Ide�l l m im)
Personally Knowry� OR Produced Identification
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Type of Identific oauced����� K A0i.'
Type of Identification ProducedYIRKAF?
Commission NO. :'iQz S�iIQ�MISS�N �i
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Commission No.42 (Seale
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DATE
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INITIALS