HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number:
BY
- St. Lucie County RECEIVED
•
-___ _ � yptg
Building Permit Application ntting
per miOCT
Department
Planning and Development Services PermittingSt. tingLuc
county
Building and Code Regulation Divislonr� - -
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
-
PROPOSED IMPROVEMENT LOCATION 17.
`+�
Address:1394a s 0/'Dll4 LAY✓P rsTPd fD'� �D ��gs'%
PropertyTaxlD#:}t �a_SCsc2-f�[7n(�-pdp_t�
Lot
No.
Site Plan Name:
Dom{
-OZe4m(1 �rlg1'A
Project Name: Block No.
DETAILED, DESCRIPTION OF WORK 77
:CONSTRUCTION INFORMATION
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping —Shutters _ Windows/Doors
_ Electric _ Plumbing —Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
.Cost of Construction:$ ' It t gs Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE.
£QNTRACTOR
Name OQSAl10 D� Flutr�: P �
01 T-26a n (� Name:
Address:-c6w S (}eyam Ii ,'t,p-
Company:
City: +deYbf4J ✓&h State: Address: I
Zip Code:,-?49 CJ Fax: -272 _ 2ZA - City: State:
!%''l
Phone No. QL -%%� Zip Code Fax
E-Mail: 00eLlr7a nor.. h, r7 hone No w^ �- ( (S',�
Fill in fee simple Title Holder on next page if different E-Mail T
'
- -from
the�ownenlisted-above)u-State•or-County-License- -- - - - -
If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
Name:
• ^rr�auie
Address:
City. State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFI
MORTGAGE COMPANY:
Name Not Applicable
Address:
City- State:
Zip: Phone:
BONDING COMPANY: _Nat Applicable
Name. __ ... _ . ..-
Address:
City:
Zip: Phone:
DV1I : 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.
which 15 Count lfiicmt with any applicable lHome Owners LAssociationirules authorize
ylaws othe
and covenanitds that build
o�� 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 1 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 W YOUR PAYING
TWICE FOR THE
SITES TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF CRY
YOUR
/� LENDER OR AN ATTORNEY BEFORE RECORDING YO YOU INTEND TO OBTAIN FINANG CONSULT
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTYOF
The for oing instrument was tknowiedged before me
this
/�1, day of =k 20� by
Nam�eofpersonWriakmgstatement.M .
Commission No.
REVIEWS
OR Produced Identification
UR NOTICE OF CoINMFlureue. n '
Signature of Contractor/License Holder
STATE OF FLOI DA
COUNTY OF 57,y✓�,
The forgoing instrum nt was acknowledged before me
this 9 day of 20_t q bv....
Name ofperson m king atement. �� VAT•• oy r
/ :Ajy )IIIBER/j is ,CO
Personally Known ✓ OR Pr
oi�iyef] IdRltification N N•:
Type of Identification
Produced ; z :c iaysis
�9 .9Bo .
N
Mary ublic-State of Florda) (Slgnature of Notary public- State o.I
f Flari a')//1/11111111\
it FANYFERGUSON ommissionNo._- (Seal)
Notary Public - Slate of Florid
am ec on IF
FRON ComgiR89SilqR2 pp DNS VEGETATION COUN Albou y rn IEW SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW