HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMi �cIcD FOR APPLICATION TO BE ACCEPTED _
Date: % O Permit Number
SCANNED BY RECEIVED
(,
St. Lucie County
JUL 1'!t`$019
Building Permit A'Ppliez tion
Planning and Development services Permitting Department
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (7)2) 462-1578 Commercial_ Residential .
PERMIT APPLICATION FOR: � u �,r c ® Y-n
Address:LlzrC f"e o.3 Fil, eiC
Legal Description: 1&k0_,9 ce i , Ntje. b 111e0. o�70od 1 �� 4 SO63
1�r;�r ab3
PropertyTaxlD#: 13a7- 701-/ Lot No.
Site Plan Name: 4A? Block No.
Project Name: Ewv'eJ
Setbacks Front Back: Right Side: Left Side:
Aa/�/.+�pAC ,OtLr9r�7i✓� c�'� ��e .tsa, flea✓ r.�)hAot✓ �.c.7v+.r�,��
Additional work to be performea un ert is permit -check all that apply:
_Mechanical _Gas Tank Gas Piping [Shutters —Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof ' Pitch
Total Sq. Ft,ofiConstruction: Sq. Ft. of First Floor:
Cost of Construction: $' Utilities: —Sewer Septic Building Height:
Name e - /. - :'
/ Name -
Address:
^9c/ir� T"!4U/� ✓.adw..c ' Company:Locif
City: State:-; Acidness: 2 r
Zip Code:Fax:, -.1/ 4 - City: /C{. /, e✓Cc State:
Phone No. aZ& 'a f'o % Zip Code: -71-/9 I S Fax: -272- V6 68.1 r
E-Mail: Phone No Ji1 y6J//6
Fill in fee simple Title Holder on next page ( if different E-Mail to �L/aheo . CaM
from the Owner listed above) State or County LicenseCCG/3!/S/.f08
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
R
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable
Name:(jer�at,;4!� Fr�g�neer��y Name:
Address: 06 Ave Address:
City: FYI, eiee State: F/ City: State:
Zip: " . 'Phone -:7G Zip: Phone:
FEE SIMPLE.TITCE HOLDER: Not Applicable
BONDING COMPANY: XNot Applicable
Name: ,
Name:
Address:
Address:
City:
City:
Zip: Phone:
ZIP: Phone -
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made 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 Counttyy 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 our Notice of Commencement.
ignature of Owner/ L ssee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA - STATE OF FLORIDA
COUNTY OFL COUNTYOF��
The forgoing instru t was acknowledged before me The forgoing in u nt was acknowledgeo,�efore me
this day ofL A 204, by this
—)-_Qdayo 20 by
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Name of person making statprnent. Name of person making/statement.
Personally Known / OR Produced Identification Personally Known ( OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature
��.
of otary Public -State of Florida Signature ofof Not Public- of Florida)
of Florida )
Commission No. s?!"•`-•?i; _-� AtIDREYB UMPHREY -�
-m. ;_♦= OMMISS JaG300817 CommissionN a'4."•":"•••, AUDREYB.HUM(- i4
=.� ..... 'EXPIRES: March 6, 2023 ':,: MY COMMISSION G GG 30P817
+� -
. ..,...,,,, .a EXPIRES: March B, 2023 -
m;Fori.`.°"`Bon
ThrUNDIMPUbMU weaam ..
REVIEWS FRONT ZONING .5QPERVISOR PLANS VE y'GROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.