HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I �(t� �`� SCANNED Permit Number:BY
St. Lucie County
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Building Permit Application
Planning and DevelopmenrServices
Building and Cade Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Resident)alx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: I ei M A &1:h Ls"P— Coo
Legal Description:." t IkMuy. ct_ob �?L.r•T 1h&mss �att-r- 22 Co r 3(�
PropertyTaxlD#: 34 S ^Za$.btao.c,00- Lot No. 3�
Site Plan Name: Block No. A
Project Name:
Setbacks
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Total Sq. Ft Of Construction: Sq. �Ft. ( of First Floor:.
Cost of Construction: $ S08S a6 Utilities: IJSewer ElSeptic Building Height:
Address:$S IZ MAki,SMg" Qr
City:_?*QT' 'S-t Lmce State:'
Zip Code:34as2- Fax:
PhoneNo."1'1Z iSYLJ tol
E-Mail•
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: WefCC At-�Q.'AA
Company: CLenu Aiti T6cHNa�c�c yes
Address: LS'1% W B M9LY4& lc ektLe e
city: !Nt rx a- L.ueiG State: FL -
Zip Code: Fax:777- 3YS--led a
Phone No. iT•t— '33S` 2.4161
E-Mall:CLe6Ao iS�72 ® AeL. cc,r.,
State or County License: C2ACo X 86 6 D
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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MORTGAGE COMPANY: _ Not Applicable
Name:
DESIGNERANGINEER: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _Not Applicable
Name:
BONDING COMPANY: —Not Applicable
Name:
Address:
Address:
city:
City:
Zip: Phone:
Zip: Phone:
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 authorise 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 your Notice of Commencement.
Sigrk&ure of enU Lessee
STATE OF FLORIDA
COUNTYOF ST Lvt.tr Coor.fi�)
The forgoing instrument was acknowledged before me
this:& day DQSWC-M6EVit 20 14 by
Sign ntractor/License Holder
STATE OF FLORIDA
COUNTYOF 5t Lochs Cwmt
The forgoing instrument was acknowledged before me
this �L 46day of NvO6mJ3dA, .20--IA by
'C:4 At,me�J�. I ,ALrr%e..3A
(Name of person acknowledging) (Name of person acknowledging)
_ L%f�W]9tsL
(Signature of Notary Public- State of Florida )
Personally Known ✓ OR Produced Identification
Type of Identification Produced
Commission
MY COMMISSION #FF091110
Revised
(Signature of Notary Public- Statteof Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. j SANO((�1 WALSH
1.6 -' MY COMMISSION ,tFF091118
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SUPERVISOR
PLANS
VEGETATION
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MANGROVE
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INITIALS
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