HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: - `- Permit Nurrber:
RECEIVED
Building Permit Application JAN 2 4 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Gorrrr-rcial Residential
PERMT APPIJCAM ON F0P_ To Select fi-cmdqDbox, dick arrow e t the end of I i ne
PROPMED I M PRG/EIVENT LOCATION:
Address: /L;'-b c V C e- r(:)r 4 P r c-
Legal Description: .T.o d,'a n i1q; Ue r J�5-1A4s -un;4 o9 - 81/< IS' ),04 r) C,,4-iaP 3 y/zN)
Property Tax I D#: 3 y 0 -) - (,10-oa3.2 -4C - 1 Lot nb.
Site Plan Narre:— Ta /a n JR�✓er �S�A S Block No.
Project Narr2: Aco� d- L nary Murae)K6S
Setbacks Front Back Right Side: Left Side:
DETAJ DESCRIPTION OF vAowe_-
e 0.ncJ � � nla � � h Crq�age cd
QONSTRUC171M I TION:
Additionalvvxktobenettom-edu rt is perrrit-check all apply-
El
y:El HVAC _Gas Tank [:]Cas Pi pi rg Shutters ❑VSA ncloo6/Doors
11 Electric ElPIurrbirg OSprinlders �_Generator Roof
Total Sq. Ft c►f Construction: Ft.of First Floor:
Cast of Construction:$ � , D/ 3.c Utilitiess Se",er Septic Building Height:
O\MVER/LESSEE: OOMRACFOR:
Mrre �A�( Y►I Dnp/ <�i nd�( �V c a n KuS Narre: D0.�Ia.S AA ( k e V
AWress: 5-'709 s roce \Dr' CorparV. OVe.c-hea0 Door of 4Aetresur-e ccc s�
City.. C50 r j P-'e rce Address: 3 7 5-5 f= Sc.a 1 C }
Zip Code: 3`/9$,2 Fac City R ;y:e� f3egch state��
Phone No.—?) y - 'I Ii S 5- Zip code: 3 3 y 0 y Faoc$-(oi 8 9-9 7 0 a
E-N/fail: nn U r0.n K u S r L) y a.h va co." Phone Nlo, SG 1- 8 8/-9'10 0
Fill in fee simple Title Holder on next page ( if different E-Nbil: C I SOA of Ove -Aeadeloor+c.00r"
from the Owner listed above) State or County License: C13C- 12.Y9.29a
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SL PPLEIVENrAL OONSTRLJCfl0N U EN LAW 1 W0RNA-noN
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Nacre:
,oddness: Address:
city.. State: city. State:
Zip. Phone Zip: Phone.
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Nacre: Mme:
Address: Address:
Gty: GtY
Zip. Phone: Zip: Phone:
certifythat no work or installation has comTynced prior tothe issuance of a perrrit
St.Lucie Grrukes no representation that is granti re a}grit W II authorize the permit holder to build the subject structure
W ich is in conflict with any applicable Hare Owners Association nles,bylaw or and ca enants that may restrict or prohibit such
structure Please consult vuth your Hare CWiers Association and reAewyuur deed for any restrictions v huh nW apply
In consideration of the g-anting of this requested pen-nit,I do hereby agree that I W1I,in all respects,performthe v-ork
in aomrclanoe with the appro4ed plans,the Florida B.ilcirg Codes and St Lucie County Am3-idnmrns.
ThefdloWng building permt applications are exempt fromu•rdergoirg a fill oaraa•rexy reAevv.rocmacUtions,
accessory structures,svu rr m rg pods,fetes,walls,signs,screen roars and accessory uses to another nor-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
i rrpraerr-ents to your-property.A Notice of n•ust be recorded and posted on the jobsite
before thefirst inspectior-L If you intend to obtain financirg,consult with lender or an attorney before
con nenci work or recording yoLr Notice of
S
Si Omner/Lessee/Agent Signature /looms--Holder
STATE OF FLORIDA �7 STATE OF FLORIQA
COUNTY OF PC I "i &-O-C h COUNTY OF A�/►1 13eac h
Theng instiuen
rt was admoWeclEpd m
before rm TheforEprg instnent was ack r DkAeckad before rre
this_dayof ,renuo-r-i 20 /Eby this `I dayof -SAnJacy 20 1 S by
�0.�las ,� ; IIF �a11a5 � Ilei
(Narn--of person advxanle*re) (Nacre of person adgxWed®rg)
air
(Sigrratrre of Notary Pt ilio-Stkeof Florida) (Signature of Notary Public-Stat9of Florida)
Personally Knovun ✓ OR Produced Identification Personally Known ✓ OR Produ ced Identification
Type of Identification Produced N of Identification Produced
t CAI HILEEN WILSON
Ccrrrrissicn Na j NqWYPUSUC Crnrrrission Na NOTA � C;
STATE OF FLORIDA STATE OF FLORIDA
Revised 07/15/2014 Expires 9/7/2019 t Expires 9/7/2019
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DATE
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