HomeMy WebLinkAboutBuilding Permit Application �► � i' =�;� , -� � �' C.�.LMS:
i ALL APPLICABLE INFO MUST BE COMPLETED FO LCT - TO BE ACCEPTED
Date: 10 PEWAITTING Permit Number
St. Lucie county, FL
Building Permit Application RECEIVED
Planning and Development Services OCT 14 2016
Building and Code Regulation Division
2300 Virginia Avenue,t=ort Pierce Ft 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Demolition
PROPOtE-DWPROVEMENT LOCATION:
Address: '� ��� l �a��,�es�y�� C� , 'T (��erct� C
Legal Description: 0-9e e. e P\ J
Property Tax!D#; .Z 3ZC�- {0 00 (DC7 Sa "' UCS 0- Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION;+C}FVORK
ND NvAI f �� wArz Ga.�nG`r �"'s
Na SGv+�2 Conn eclr�zs✓`S / /V rt L GtfL1
CONSTRUCTION'INFORMATION.-
Additional
ORMATION:A itiona work to (eperformedunder this permit—check a appy:
F1FIVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
FlElectric 0 Plumbing F]Sprinklers FlGenerator M Roof Roof pitch
Total Sq.Ft of Construction: Scl.Ft.of First Floor:
Cost of Construction:$ 2-, X__)0 Utilities: Sewer Septic Building Height:
01lUNER/LESSEE: CONTRACTOR.
Name t h �,� � Name:
Address: (L- SD U-%vlf - rz PJ Company:-- -mss 'w1 C
City: Stater L Address -Aao o S__
Zip Cade: Q' I Fa City: State:V L
Phone Na. 32 �- ? 2- Zip Code: S Iek 0-1 Fax:_r--
E-Mail SCLES Phone No. SZ-(- 733-Z-( (!
Fill in fee simple Title Holder on next page(if different E-Mail: _ Sjl_L D+z t+Q
from the Owner listed above) State or County License: 7_`' C)(_0
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION,,LIEN LAW INFO AT16N.'
DESIGNER/ENGINEER: —Not Applicable MORTGAGE COMPANY: v"'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.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
commencing work or recording our Notice of Commencement.
s
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDASTATE OF FLORIDA
COUNTY OF �Q COUNTY OF 4 �
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 201c,., by this 1 day ofOC:V60�-2— ,201 Ca by
(Name of person acknowledging) (Name of person acknowledging
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known go "n R16cation Personally Known i� OR Produced Identification
Type of Identificati ed � mwisslON,#FF 957aoo Type of ldentificatio
`* #' EXPIRES:Februarys 't�" Y'= MY COMMISSION#FF 957800
c Undemtitess '*: :*"
Commission No. ^'a _ �Q` .. EXPIRES F{x}27,202a
BondedThruNo Commission No.
pF y° Bonded Thru Notary Public Underwriters
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS