HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONa
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number. I`lV`l•�?��i'I
BY
St. Lucie County QED
Building Permit Application
Planning and Development Services y�.mItting DePIr"Cat
Building and Code Regulation Division `r St.Lucie County
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 111111
I KKUNUbtU-IMPKUVEMENT LUCATION: : flll
Address:
Legal Description:
Property Tax ID#: 4511- SIS —DOSa--ow- I Lot
Site Plan Name:
Project Name: , to Yl I - -,Xor(llll
Setbacks Front Back: Right Side: Left Side:
Block No.
DETAILED DESCRIPTION OF WORK:Jill
lberno 2ePlual K%44icr� A%:naAS Your- A/c SL(ct
r�xu ciao l 1nS4G1% hEW Slr)L ICO-60 D,5>71 t W t d A SO LI, r�
,Mbijlt- CICLkIIcll�IXon.�- 1 1'nSlal i.eu CUn I)Na ICe;tl�fatCNa (%hS'klit Tr;i,&A R2L'l7Sad-GltnS. i
CONSTRUCTION INFORMATION-
HVAC Gas Tank
Electric 1 _15lumbing
Total Sq. Ft of Construction:
Cost of Construction: $
Piping UShutters ❑Windows/Doors
nklers 11 Generator 11 Roof
So. Ft. of First Floor:
Utilities: 0 Sewer D Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: r rC)
Address: lD°a)n S. t.lcean bt-1. Uh J-6oK
Company: RrLkCn l n on-.4a(d t'Q)i mil' .
City:-Xtyunq!�taui. State:
Zip Code: 34951 Fax:
Phone No.( �51b)'>S3 •-13%G
Address:- � 1011 k)�/�SnfnSerN 6C. I >1vd .
-li
City: _)I K-> P ,Cfw . State.
Zip Code: 31l -7 Fax:7?a-�j%S-/�)aa
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above) '
E-Mail::SPtVI[ e�D-Pal1(n ielw5 CC% 1 Orl��('..( DI
State or County License: cC e I �131 I
If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required.
LAW
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
v Not Applicable
MORTGAGE COMPANY: `�NotAppl)cable
Name:
Address:
City: State:
Zip: Phone:
Applicable
Name:
Address:
City:
ZIP: Phone:
BONDING COMPANY:
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 contlict 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
befor2 the first inspection. If you intend to obtain financing, consult with lender or an attorney before
compiierft, ing work or recording vni irAlntirc . f rn _.
STATE OF FLORIpp�p STATE OF FLORI A
COUNTY OF �IGYI (ham COUNTY OF bL6r VL_,
The forgoing instru ent was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 / by this X day of 20 b
/! Y
(Name of person acknowledging) (Name of person acknowledging)
(sign, ure of Notary Public -State of Florida )
Personally own OR Produced Identification
Type of Ide tific PG4 uced-iFNNAL.FRANCo
�� ...
2°' k Commisslon#GG 23 fi9'
Commission No. N ` xpkesA0451R023
��F'orR°p BonCaOTIw BuC7elNale7 6
Revised 07/15/2014
(Signat a of Notary Public- State of Florida)
Personally nown OR Produced Identification
Type of Ide icat!on Produced_
Commission
JENNAL.IMO
mmiselon 8779
NplresAprI129. 2023
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