HomeMy WebLinkAboutBuilding Permit Application _ - - --- __
2016-05-31 07:,54 AMETHYST RECOVERY 772 800 7723 >> R2I5
ALL APPLICABLE INFO MUST-BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -j� Permit Number._ __
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Building Permit Application MAY 31 201
Planning and Development Services PEH.•ll' HIG
Building and Code Regulation Division St. Lucie County, FL
2.300 Virginia Avenue,tort Pierce FL 341£32
Phone:(772)462-ISS3 Fax:(772)462-1578 Commercial _ _—_ Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address•—���i �7.�7�a 7 �..fi —�_._��F���•�:_._.►��———--—————
Legal Description:.— T c tf t f'C' - 'moi{r;�F�,�L�'�✓ —— __ —--- __ _ _ _ .— .
Property Tax lD#: 17 --6�0fl
Site Plan Name:_ __.—� ej,"� e tis L __ —— —._ _———— Block Nt,...—.—•-
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Setbacks Front____ Back: —_Right Side:--—.Left Side: _-
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�A'dditior l Nor o", e e armed un er is perm —ch�:c a 1' appy:
0NVAC 0 Gas Tank ❑Gas Piping __Shutters �Windows/Doors
Electric: El Plumbing Sprinklers 13 Generator 0 Root'
Total Sq.Ft of Construction:_.
onstruction:_ SQ.Ft.of First Floor:
Cost of Construction:$_ j - __— Utilities: Sewer L_I Septic Building Height:
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Name—.__ � Grr1/tlOr�/ —.__.—.— Name: — 4 5QA/ {O jSi�✓ — ———�-- —
Address:—f0j, O tt r' __. _—__.. Company:
City: t'/C ' State: Address. TCG Ltfi 3�--._-,__._—
Zip Code:_• cCf rax: `7 — City:— Staid
Phone No.,—C7?Z-jCZ��7 •. J ---- Zip Code:.E.Mail:_ —_ _. ____..____ _ Phone No.
Fill in fee simple Title Holder on next page(if different F-Mail:_—�-aj0Dt/
from the Owner listed above) State or County License:
if value of construction is$2500 or more,a RECORDED Notice of Commencement Is required.
2016-05-31 07:59 AMETHYST RECOVERY 772 800 7723 >> P 3/5
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name., Name:
Address; Address'.
City: State: City: State:
Zip: Phone: Zip: Phone;
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: 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.LucleCoun 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 ancovenents 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 Adiendments.
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
your property.A Notice of Commencement must be recorded and posted on the jobsite
before the firstlospection. If you intend to obtain financing,consult with lender or an attorney before
commencw-work or recording vour Notice of Commencement,
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Sig f OwIlier/LeVee/Agent Sign e%f Contractor/License Holder
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E OF FLORIDA 5 ATE OF FLORIDA,-,
NTYOF-- COUNTY 0
The forgoing instrument was acknowledged before me The,fpo[going instrument was acknowledged before me
this &Iiay of JU A., 20 va-by this;j�n_day of- nQ,>-J 20 �-k—o by
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(Name of person acknowledging) (Name of person acknowledging)
(Slgnt,�-Oootary Public-State 6f Florida (Signature of Notary Public-$late of Florida
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Personally Known OR Producedidentification Personally Known OR Produced Identification
Type of identification Produced- z-tk A Type of Identification Produced
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Commission No. 3 Commission No.
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AnAl 911,20101
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Revised 07/15/2014
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