HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE C OMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1:7% 01`�` �° Permit Number:
it RECE! D S E f 2 9 7016
Building Permit Ap lication
Planning and Development Servicest. Lucie County
Building and Code Regulation Division Housing Department
2300 wf: inia Avenue,Fort Pierce FL 34982
Phone-.x(772)4.62a5s3 :rx:1772)462-157.g Domesidential
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Address o� C
Legal Description: L-��4 O Vu e�� "\ S 00 �04 i/®J 26 �
Property Tax-1D##,:. (0 S j - O Q r 'Lot ho..
Site 01�n dame: Vo�\2 T)
Protect Name:
Setbacks Front [rack: Right Side: Left_Sfd'e:
Cook
aN3
WFORMATI
Acfc[ftfona[work toa performed under this permit-check a ap fr y:
E1d�VAC EI Gas Tank Lj"#�fpi _11-Shutten. , Windo i�t�ass
..Electric 0.Pl.u.nmbing O,Sprinkl:ers I_I,Generator LTJ:hoof PTO;IZ , Roof pitch
Total Sq. Ft of Construction: ® 6 Sq. Ft.of First Floor: O 65
.�Cost�of-Construction:$. 1 00 UtIl iities:1Sewer-1:nn1,Septic Sidi ding-Height:
OVVi�lER�LE�S� � = CL?61ITRAC-�C�R
NameQ\i Udo ��
_ Name: �tS�Cci o
.ate
Address: 21 ID A k) �vrnpany ue_�� Lmnp:MZ0 C:�`\e)N3
City: State: FL. Address: 2�V3 31 3-�
Zip Code: -2 A°l Co Fax: City: t1z_t oLUC\ 15tate�
Phone No.:��V Z- 1`�� �Q Fax: P fit
E-Mail: Phone.No. ` Z - -5 7 1-4q¢T
Fiflin fee simple Title Holder on next page(if different
from the Ow.nerAasted above) State or County.A;icense: CCc_" 13 3 O 6 Z3
if value.of.construction'is$2300 or more,a RECORDE),Notice of Comff enteme-ftt is required.
StJPPLEItiIiEi�T��CQ�lSTRL'TOLIEN,i.Af IRMT'9Q °
DESIGi ER/EN&NEER: •N 't ApPli -able Rr1ORTGAGE'COMPANY; _Not;Applicable
Name: J, Name-
Address: . Address:
City: State.: City: State:.
Zip: Phone: Zip: Phone:
FEE SIMPLE TITd HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
Zip: Phone: Zip: Phnne:
l certify that no work or irrstallation,has commence&prior to the issuance of a:permit.
St.Lucie County makes no representation that is granting a permit will authorize theermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or andcovenantsthat may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
fn eonslcferation•of.the granting,of this requested permit,I`do.tieref u agree that r will,,in all respects,.perform.the work
in accordance with the approved plans;the Florida Building Codes and St.Lucie County Amendments.
The:follow+erg.'Iyu! ing peran t•apportcationsar.:e exempt from—undergoing•a fdgl concurrency review:ar-oom,additions,
accessory structures,swimming pools;fences;wa[rfs;signs;screen rooms and accessiory:uses to sr vtfierndn`` resi fetitial Esse
WARNING TO°O13 NER::'Yourfailureto'Record.aINcitice.df Commencement may'res.ult inyour payingtwice for
improvements to yotar properly. A Notice o 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 our Notice of Commencement.
Signature of D.Wner/Lessee%Contractor asAgent for.Owner °Sdgnature of Contractor/License,Kolder
STATE OF FLORIDA � STATE OF FLO!
?&
COUNTY OF_] COUNTY OF G J
The forgoing instru ent las ack owledged I efore_me Tf►e forgoing instrument was ao owledgecl.before me
thlsM day of ED Lkby rhis•(P 7 day of 20,Z by
(Ua -of person ackffow4ed'g1ng Y' Na&4 o€-Person acknowledging j
tP+h
(Signature offttary Pubic e.of Florida;} (Signature o;;� :ry Public-State o€Florida.,}
Personally Known OR Pr t. U Known ��GR Produced Identification
",• L'CA�E MCI E>� a of- :entifir^ation:Produced
f�+pe of Identification Produced ••.�R1O�e�• yp
<. . ry u c- tat'of Florida sT
Commission N FF fl�1�6mi iori Nol�r 7 �b�b ,'o���������
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Commission No. "s;? :_• . Notary Public-Stat f Flo
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