HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� Permit Number:
- , =
4_10
RECEIVED
Building Permit Application
Planning and Development Services
JAN 2 4 20�a
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ST. Lucie County, Permitting
Phone: (772) 462-1553 Fax: (772)462-1578 Commercial Residential _ X
PERMIT APPLICATION FOR: 2-e__2< D r'
PROPOSED IMPROVEMENT LOCATION:
\Q�CJI
Address: _6 aoC �.L�c`« \JCA -� Cf 1 (7_ 3� _—
Legal Description:LAKE W00-DI '�WM06T S� '�)\Y, 0% f!6T --A-
Property Tax ID#: A3Qk-G AA ^Q3 5 0- CQQ - "J Lot No.
Site Plan Name: Block No. n ng
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
29o.�i - , IN s-toy\I �n-ev.� ►,ardl�v��,o..y ►rn e►�t�
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CONSTRUCTION INFORMATION:
Additional work toe er orme under this permit-check a appy:
HVAC E]Gas Tank E:JGas Piping _Shutters Q Windows/Doors
Electric El Plumbing Sprinklers Generator Roof F5 1 ft:4 Roof pitch
Total Sq. Ft of Construction: lC S . Ft. of First Floor:
Cost of Construction: $ �.�.�.� Utilities: _Sewer Septic Building Height:A—
OWNER/LESSEE: CONTRACTOR:
Name 0\0i ce_ Name: �C�dL
Address: Company: S S
City: gA_ i-ev_cp, State: -V-L. Address: :�.� 1�Y`t" i.
Zip Code: 349_3A Fax: City: S-� 9�' Q_* Stcatter -�
Phone No.�4 - 1919,; )-- 03O Zip Code: 3^ Q0l'4- Fax:4AA _) O-tom." ac�,v33
1
E-Mail: 6 S -Phone
Fill in fee simple Title older on next page( i di erenth E-Mail: t \ S ��5.
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from the Owner listed above) State or County License: C-C-r— ^ 3
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 thepermit 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 o cling our Notice of Commencement.
Signat of Owner/Lessee/Contract Age&fef Owner =TATE
f Contractor se Hol
TATE OF FLORI RI
COUNTY OF COLIN OF
The g�jpg indent was acknowledged before me The org instr ent was ackn wledged before me
this �y of .�i��.il�. ' ,20 % by this �y ofp�aL 2M
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Name of person making statement Name of Qersog making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary P -State of Florida ) (Signature of Notary P lic-State of Florida)
Commission No. (Seal) Commission No. (Seal)
BONNIE LOVITT �H_:�' BONNIE LOVITT
_,o. g
EXPIRES Se 3tember 17,2021 ••2021WFES Se lamb r t7 1
REVIEWS FR NT ZONING SUPERVISOR PLANS VEGETATION 'SE`s UltllMNG OV�0
COU REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17