HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date, Permit Number:
[ V E
7hi D
Building Permit Application OCT 2 6 9-016
Planning and Development Services PERruqITTING
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: I ) a0 Ca-u Lu
Legal Description:_CQ L)KS" 4l ulvimlzl Ez; —s- -E�Y- Ln K
Property Tax lD#: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
g, 0g. g, p. ge'� gwgw
HVAC L=,1 Gas Tank oGas Piping _Shutters ��Windows/Dom
�Eiectric Plumbing Sprinklers Generator Roo
Total Sq.Ft of Construction: So.Ft.of First Floor:
Cost of Construction:$ 01 q go). 9, Utilities:0 Sewer FiSeptic Building Height:
Name T�tcc , N a m e:�p-c> S - Q� e C-
Address: k-) DQ O-V> LYS Com pa ny.—Z".0o,r�.
City: lilx e'r r, ::e State:,E-L Address: 14 (Q -7q
Zip Code:3 4-a4 C%— Fax: City: LZ a`ffi k pL-J &c,- Q.-�-, State._F
Phone No.--)'7;A,. 3 3a - ld- Zip Cocle:133L) I QL Fax: 57-61 q0
E-Mail: Phone No. ��l- 5S 0:5-
Fill in fee simple Title Holder on next page if different E-Mail:
from the Owner listed above) State or County License: G- 0 0
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
DESIGNERANGINEER: _Not Applicable MORTGAGE COMPANY: ,Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
r� 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 recordinR vour Notice of Commencement.
5
_Signatur o€Owner/L s gent U&ure of Contractor/License Holder
STATE OF FLORIDA J STATE OF FLORIDA.
COUNTY OF t� LPL " COUNTY OFC. _
The for ing instrument wa acknowledged fore me The for oing instrume t was acknowledged before me
this ay of o 20/�by this day of o� 20 by
(Name of person acknowledging) (Name of person acknowledging)
P{Signature of Notary Public-State of Florida) (Signatu of Notary P7�::roduced
iS to of Florida}
Personally Known OR Produced en 'fication '� Personally Known Identification
Type of Identification Produced ��. Type of Identification Produced
Commission No. 7 {Sea31 Commission No. ��pt2vFue�, At1s� I�rso
V Vl�&NNE A FINLETTE * 't * MY COMMISSION#FE 951463
NOTARY PUBLIC r � EXPIRES;April 12:2020
STATE OF FLORIDA TsoF Pwo� Sanded Thr.budget Wary Services
Revised 07/15/2014 Comm#FF044568
MWEXIDIres 8/11/2017
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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