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PPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
ate:
- Building Permit Application DEC 0 3 2015
Planning and Development Services PERMITTING
Building and.Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Plerce FL 34982 .Residential X
Phone:(772)462-1553 Fax: (772)462-1578 COn'1CT1erCIal
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line t°C Yr
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PROPOSED
.,. ..,
Address: 4703 BUCHANAN DR FT PIERCE FL 34982
Legal Description:
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Lot No.
Property Tax ID
Block No.
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILEDDESCRIPTIQN OF UVORK
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CONSTRUCTION INFORMATION
Ad
=rtiona wor .to a er orme un er this permit–check a appy:
HVAC F]Gas Tank. F]Gas Piping _Shutters Q Windows/Doors
Electric D Plumbing Sprinklers Generator El Roof
Total Sq.Ft of Construction: Sq- Ft.of First Floor:
Cost of Construction:$ �� Utilities: Sewer 0 Septic Building Height:
Name Federal National Mtg Assn Name: i�` c'✓�?ti Rw� _
Address:PO BOX 650003 Company:
2
City: DALLAS 5tate:TX Address: I n��/or��' �F ��✓
Zip Code: 75265 Fax: City: Whn Stater
Phone No.407-402-9576 Zip Code: 3ZY2/1 St Fax: 37%-zf/!- Gzio/.
E-Mail:tristateworks@aol.com Phone No. JAZ%- 727 4 .95— J
Fill in fee simple Title Holder on next page(if different. E-Mail: • �7
Co /•Ccc�
from the Owner listed above) State or unty Licenser �i f 3� /2�7
If value of construction Is$2506 or more,a RECORDED Notice of Commencement is required.
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11/11/2015 permit application1.jpg
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SURPLEMf TAL CONSTRUCTION LIEN LAW IIVFORIVI`ATION
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: NA Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable
Name: NA 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 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
comm en ' w rk or recording our Notice of Commencement.
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_Signature o Ow r/Less S' t e of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA _
COUNTY OF COUNTY OF
The forgoi , t�4it�ht w�-d5-ackno The forgoing instr ment was acknowledged before me
this I da {_ 1Vo v.-zv,', --AR1E U8 this 15—day of 20 by
18,2019
(Name of person acknowledging) (Na�Yie of person acknowledging)
�r °c MY Cbi&SSlON#FF24IWO
(Signature of Not - 118'.2019 (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification� Personally Known OR Produ d Identification
Type o en ! ication Produced Type of Identification Produced (,�D-k-
Commission No.
(Seal) Commission No. "" KAREN S. NIELS N
-� - Commission p FF 11 337
es
Revised 07/15/2014 °FFA .lune 12, 2018
a:
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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