HomeMy WebLinkAboutBuilding Permit Application Q
FFALL APPLICABLE INFO MUST BE COMPLETED FOr, LCAt1 'FC3;$ ACCEPTED �
Date: 1b- t t--1,-1 (_-� QCT Permit Number:
' - PEP°011-TING
_ St. Lucie County, FL
Building Permit Application
Planning and Development Services OCT f 4
Building and Code Regulation Division /
2300 Virginia Avenue,t=ort Pierce FL 34982
r Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Demolition
PROPOSED-IMPROVEMtNT LOCATION
Address: s6 sue. F arc {....
Legal Description: +_Reel�s i A - --
Property Tax ID#: c;L�-q( " (a 6 d ^()Uq q q Lot No. q (-
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED-DESCRIPTION.OF WORK;
Src �- e nne Cr�b .,s '/V 4P LC CE
[C' ONSTRU'C' T'1'O' N INFORMATION:
Additional work to (ee orme under this permit-check a appy:
1_1HVAC U Gas Tank F_]Gas Piping _Shutters Windows/Doors
nElectric F-1PlumbingSprinklers E Generator F] Roof Roof pitch
Total Sq.Ft of Construction: SQ.Ft,of First Floor:
Cost of Construction:$ Utilities: Sewer F]Septic Building Height:
bWN0/LESSEE: CONTRAC OR-
Namer� Name � fl:y.c�Sc7�J
Address: lLk SQ 0' 0W-P— fz K)E. Companv- +� �
City: StaterL Address: I qSO
Zip Code: 0'-1 FaW City: .-Q� S� State: L
Phone No. 32 y ?'>°3-- 2-( \ 1 Zip Code: 3"2q6-7 Fax:
E-Mail: S L L, Er @ iN2k1 , c 0✓— Phone No. 32_t - -73
Fill in fee simple Title Holder on next page(if different E-Mail: S&4_6--c-
from the Owner listed above) State or County License: ,
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
1
SUPPCI MENTAL C NSTR:LJCTION LIEN LAW INF69MO,014:
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.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,l 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
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this I V day of 201t_by this i day of 20\(a by
(Name of person acknowledging) _ (Name of person acknowledging --- ----
h
(Signature of Notary Public-State of Florida j (Signature of Notary Public-State of Florida j
Personally Known OR Produrcpdi€ _ Personally Known v' OR Produced Identification
Type of Identificatio prNAPARRINO Type of Identiflcati
UINAPMKINUY
�a•'•°th:, SIGN#F' :�*pyo.
��.• � M COMMIS =�''�•• MYOOuyISS10�#FF,�57800
Commission No. ": EXPIREs�� 27.2020 Commission Na. _*: c' � 2020
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Underwriters IBES:Feb
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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