HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 't
70a SCANNeymit Number:
�y
St. Lucie Countv
F1 mo 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
M
AUG 19 2019
ST. Lucie County, Permitting
Commercial Residential IE:
I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line 111111
I rmuru3ty uvirKUVIzIVII:A4.I,1U_AI IYN: 'A111
Address: 'Ib5D C-X�&il )DJL. )CIPF LJ()J 7:yfl,15
Legal Description: -MA, JYJ nC_zb!>rA-
Property Tax ID #: 14 Sox -610 --ojr-�k -000 - �_ Lot
Site Plan Name:
Project Name: 7�sw),_ &dAeyt
Setbacks Front Back: _ Right Side: — Left Side:
DETAILED DESCRIPTION OF WORK:
CDYI� 4�0 a&"D, q&U2V1 41Y_7Aa_r_
J�AtC
Sji_
0 d�- R�ff 1, t�a_ ?&Af.0- Pa- L/twl
Block No.
LJGasTank
[—]Gas
Piping
L S'h'ut'ters
Windows/Doors
E�Iumbing
[]Sprinklers
0 Generator
Roof = Roof
Total Sq. Ft of Construction:
Cost of Construction: 0(36
S Ft of First Floor:
utilitiesl� SewerElseptic Building Height:
OMfER/LES_StE:
CONtRACT09.,
Name— Zlse P1,\ &0I
�.mel. C.O_K-�- ;Fmho,o
Address:- q6 tO 51 U ja^ bil. W-� Yd I
Company: 6CL1,t_Cn Onn-iki
(:k'o),
City: sfn�),Ir r2>Lavi-, —State: iE�-
ZipCocle: Fax:
Phone No. -ou I
Address: [Oil
City:
Zip Code:
Phone
State:
Fax:
E-Mail:
Fill in fee simple Title H�Ider on next page (if different
from the Owner listed above)
E-Mail:,5 y;c�-Pmyica
rcyr5A-rtkcEt)nju .—,b
State or County License: C-G-6,15-1_1191
it vaiue OT construction is �oZWU or more, a RECURDED Notice of Commencement is required.
Name:
Addresi.7 ---------------
City: State:
ZIP: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Addresi.7 ---- I
City:
ZIP: Phone:
MORTGAGE COMPANY: I-NotApplicable
Name:
Address:
City: tate:
ZIP: Phone:
BONDING COMPANY:
Name: ��Not Applicable
Address:
City -
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Coun makes no representation that is granting a permit will authorize the permit ho der to bu d the subject structure
which is in co 171ct with any applicable Home Owners Association rules, bylaws or and covenan 1 11
structure. Please consult with your Home Owners Association and review your deed for any re ts that may. restrict or prohibit such
In consideration of the granting of this requested permit, I do hereby agree that I will, in all res strictions which may apply.
pects, 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 rn�ay r ult in your paying twice for
yr u
CO/
improvements to your property. A Notice Of Commencement mu cor ecland posted on the jobsite
before the fyO inspection. If you intend to obtain financing, cons r r
commencip r1k work or rPrcAi*5;a ...... hi-+:-- —c nder o�r�attornev before
as
STATE OF FLORIDA
COUNTYOF__eyC
The forgoing instrumegt was acknowledge�Aefore me
this L�_ day of If 20 &Lby
Y"?
(Name of person acknowledging)
(SignatupiKof Notary Public- State of Florida
eer nal[yKn own OR Produced Idsormawco
� �cafion ProducaAW!fJk,_ . . _.P�q-91i7tv-
Commission
Revised 07/15/2014
STATE OF FLORIDA
COUNTY OF_,e�...
The forgoing instrume t was acknowledged before me
this Z!L day oi 20 ZV by
(Name of pers5in acknowledging)
State of
Ferilronally Kno)wn_OR Produced Identification
T412eMf1clenfification Produced
Commission N r c_�,�,Ian#GG32
O� , 11 1 sppt,129,2:
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Exp re
REVIEWS I ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
I OUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
J CFRONT
INITIALS