HomeMy WebLinkAboutProduct Ratings ALL APPLICABLE INFO MUST BE COMPLETED FOR.APPLICATIQN TO BE ACCEPTED
Date: PermitAunriber;
RECEIVED
Building Permit Application JAN 3 0 2018'
Planning and Development Services
Building and Code.Regulation Division Permitting Departmer
2300 Wginia Avenue,Fort Pierce IFL, 3498.2- L,�cie County
I
Phone:(772)462-1553 Fax:(772)4,52-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from droobok, click arrow at-the end of line
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R 'IS'N '
ROPOStbr'IM
1P. M T WCATI
Address: 5-79,"5- -^1 (277
Legal Description:
r3to 7- 6041- 000PopertyTax;lD,#: 1 5
Lot No.
Site Plan-Name: Block No.
Project Name:.-
Setbacks Front Back: Right Side: Deft Side:
R
T,�I'LiEb."06,C I.RT ION F:WQRKLi,-' -',,, ,'
)L
CONSTRUCTION,
_- AN �FO:�Rw
AdclitionalworKtobe erformed under this permit-check apply:
=7
W
HVAC Gas Tank ElGas'Piping, —.Shutters 11.'Wihdbws/D.o,drs;
0 Electric El Plumbing Sprinklers Generator Roof Roo. fplfch
Total So.Ft of Construction: S Ft.of First Floor;
.Cost of Construction:$ 3375 Utilities Sewer Septic Building.Height:
TPACTOR:
OWNER/LESSEE'- ,",-,,,,CQN
NamQ,,,. + 5A-'C,—C r3.,k-, Name: is S C_' Li A't&q -'s.
Address:T75:''5,5 '1`4d55 C T- Company: U.rD/F A 1, eel,,XT.,
n J A,
City: State.P4 Address:, 3 r-5
Fl. '100
Fax:. city: macer Zio Code.-:3 4'5 V6- State:_�
Phone No. '7 1- L-(`7f-I(e ZIP Code: Fa.. L Lo t1-10 7
E-Mail: Phone
hohe No. Ha L( V,;L 9 v-
,Fill in fee simple Title Holder onnext page(,1fdIfferent E-Mail: ?Te 16-�A
from the Owner listed above) State or County License: CAC�Vv3-(9-&-
n
It value of construction Is$2560 or more,a'RECORDED146tice'd Commencement Wreouired.
i'
�SUPPLEM'ENTAL CONSTRUCTION LIEN'LAW-INFORMATION
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not:Applicable
Name: Name::
Address: Address
City: State: City: State!
Zip: Phone Zip: Phone•
FEESIMPLE TITLEHOLDER: _NotApplicable BONDING COMPANY: _Not Applicable
Name: Name:
Address- Address:.
City: City:
Zip: Phone: Zip: Phone: I.
• I
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 oft permit.
-st.Lucie Counttyy•makes,no representation that granting-a permit will authorize the permit_holder to buildahe subject structure
which is in conflictwith any applicable.Home Owners Associatiori 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 if the granting of this eequested;perm,it,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.#'lications are exempt from undergoing a'fu11 cod currency'review:room additions,,
accessorystructures;swimming.pools;;fences,walls,signs,screen rooms and accessory uses to another non=residential use
WARNING TO.OWN ER:Your failure to Record a Notice:of'Comrhencement may-result.in your paying twice for
improvemerits to your property:A Notice oftommencement must be-recttorded and .posted on.the jobsite
before"the first inspection;.if you intend;to obtain financing,consult with lender°or,an,aorney before
commencin -w k"or record�in our Notice:of Commencement.'
Sig re:ofOwner/Lessee/Contractor asAgentforOwner Situreof,Contractor/License:Holder
STATE OF FLORIDA ` r STATE OF FLORIDA
COUNTY OF, `"c ' COUNTY OF
Theprgoing instru ent was acknowledged before me The forg-oinganstrument was acknowledged:before me
thi day of. .,►,��.r� \ 20l`'by this��dayof 20_26y
me of person' 'akin g statement �f person making statement
Personally Known 1 OR Produced Identification Personally Known AOR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary.P.uLilic-State of Florida) (Sig"nature of;Nota:ry Public-State of Florida:;);,
Commission No.. ea '.MIKE-MARTIN mmission No. :.�«��� .; (Se*wvARTiN
`6NoUry:Publlc=State,of Flork a Notary Public 8t t�:of Fladd
-+« Commission:#Fr 216951 Commission#FF, 18951,
cxplresokpl .,. .. rom E INU r,
• •�; �� `� �tl � . . sn. ��`' lith Ati :
WS .
REVIE ' FRON LANS. VEGETATIO L`
COUN- R RVI � W REVIEW REVIEW REVIEW REVIEW'
DATE.
RECEIVED
DATE
COMPLETED
Rev:8/2/17