HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONt
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED � ��
Date:-d,l It 1 SCANNED Permit Number:
BY
St. Lucie County MR2'
Building Permit Application
Planning and Development ServicesBuilding and Code Regulation Division ng
2300 Virginia Avenue, Fort Pierce FL 34982 /
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address:
Legal
l
UCZit' Q—
Property Tax ID#: L J1a,t7IX 0M� 000?
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
Lot No.-b 't�
BlockNo.() "
DETAILED DESCRIPTION OF WORK:
V&Pxose.. -P-C t l c
M _paG-i-- t, n V 1 1N ndows -
SwQft huh`A A Viorl- aka xbtl-e Iu in
CONSTRUCTION I ORMATION:
rfuwuundi wurK fo ue erformeu unuer tms perms- cnecK all apply:
1JHVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
11 Electric Plumbing Sprinklers Generator 13 Roof Roof pitch
Total Sq. Ft of Construction: 1 1 SqI.. Ft. of First Floor:
Cost of Construction: S Le OL4 S • Utilities: L.� Sewer E]Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name O Of d C?t 0SP n -
Address:
Name: LDUL)eS 14OM4P CTe75Re6
MC
Company: l w-t5
City: yk Stater
Zip Code:'�S Fax.
Phone No. L-50--77 of of
E-Mail:
Address: 7 D
City: _QyA U State: L
Zip Code: Fax:
Phone No. L-LIS ID
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: e 5 Ld -P Perm I k S six 4 , C
State or County License:
C
,r value or consRUCtlon is %ZSuu or more, a RECORDED notice or Commencement is re0fred. '
LIEN LAW IN
— tvot rvppttcaote MORTGAGE COMPANY: Not Ap
plicable
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City.
Zip: Phone:
BONDING COMPANY:
Address:
Zip: Phone:
_Not Applicable
................—,,,,,,,, mppil;a0un is nereoy mane 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 permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or any 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 resu n your paying twice for
improvements toy r roperty. otice of Commencement must 1: recorde an poste the jobsite
before the first ins ect on. If u in end to obtain financing, consuj2 avith len� r o an a me before
command wor or rat 2 vnu Nntirp of rnmmpnrpmunt
er/ Lessee/contractor a Age t for Owner
Signature of Con r ctor/Ucense H der
IDA
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STATE OF FL 'RIDA
rct
COUNTY OF a. e
rument was acknowledged before me
The forgoing' stpipent was acknowledge efore me
��by
rQ.ICYyw�^ �)0 Lq by
this Jb da of I h o ti 20
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Name of person making statement
Name of person making statement
Personally Known _ K OR Produced Ident' on
Personally Known OR Produced Ident�cati
Type of Identification
_V
Type of Identification
Produced
Produced
;eK�WJ--lo -� A
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( ignature of N ry Public -Sae f F
Signature of ota 1 c- f itirl
Commission 0 oxyk, Notary Public StatJe�9Vd da
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My Commission FF 981647
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01 tidP Expires 05128/2020
•go.ny. Expires05/2812020
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DATE
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COMPLETED
Rev. 8/2/17