HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a,\-, 1 �� Permit Number: 1 C)Q-
—'—'^ RECEIVED
Sas``" F-T'-�' _ ,_;� FEB 0 7 2018
s �
Building Permit Applicatitffl Lucie county, PermitCh
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR:'
PROPOSED INPROVEMENT LOCATION:
Address: I q
Legal Description: Sim ^ 4 Lc:- S r
Property Tax ID#: �� 111 d a0 'dd0 _d Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: '
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Frokt4 4cJL ,-
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CONSTRUCTION INFORMATION:
Additional work to be pertormed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
d
Cost of Construction: $�aO0 Utilities: _Sewer _Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name P 1 c ,ri "hL Name: c f r i GI q Ce, k
Address: Company: kjjlrict Cmc Vii' w I/m,
City: l�'�rz-c State:L�(_ Address:
Zip Code:31�71 q-5-/ Fax�75City: /-rrC- State: l` �-
Phone No. 5--c' I-OE-�—`t'Z Zip Code: 3 c1�� Fax: �7.)- c/to�o S`l F�
E-Mail: �zz Phone No 77�-yG� �3 6o
Fill in fee simple Title Holder on next page(if different E-Mail ` {e✓ 4.1cew Li �jy
from the Owner listed above) State or Coun y License
L±t
onstruction is 2500 or more,a RECORDED Notice of Commencement is required.
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 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 room�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 Commenceme
Ci
Signature of Owner/Agent/Lessee Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF c vti COUNTY OF L c
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledgeq before me
this'\ day of C 20_by this day of '�-fir- ,20by
`q�CC'\ c,.\.31, C'31c "�*_ (_ 1 -tT ' '*\d. C. gf-Ark
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary P blic-State of Florida ) (Signature of Notary ublic-State of Florida )
Personally Known OR Produced Identifical.p , Personally Known OR Produced Identification
" e #ioa P
Type of Identification Prod vlb , � �y T yp of Iden
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a .P,,. I„
Commission No. My COM
G16 2 20 1' Commission M'dISS�oN#G�C,�,,�
:Dexmber0 + :r.
Underwrhs
p P'jbl' Unuenlnie..
'+. Bonded Yhni NoU•ry — i t�F:o;: Bonded I , Nota- —
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS