HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 02
z3' ` `,— i
s
Building Permit Application 9 2018
Planning and Development Services FEB
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: To Select from dropbox, click arrow at the end of line
Address:5W-A ,06LI66ts 111-We-
Legal
11 -LUe-
Legal Description:1ndL 1 91be.P- E4 11r); P 4 61 KFiO LofS /`y 1 F
Property Tax lD#: 1340a-- (o J 0 - 0 309- 000 —A Lot No. l 7 l8
Site Plan Name: _l lu CWce-r-) Block No. $0
Project Name: e
Setbacks Front Back: Co Right Side: Left Side:
k�,
ETA(LED'QE CRIPTION OF WbR g
r 7 ,v
*10 f+ o+ -tt hilh W00C Per►c,P_ Lois 10.4 wide., dUu ble gcL ,
R.,. h
C RFp,Q INFt1RN1 iV ry § k ry 6k $£S 0
P.',.m ,u,weR..=. .1. ....K s b1 _. X?_.,.. ✓'? ..� ' '+y`�Y,z'.. .. _ "s.,.., �zk 'C�,
Additional work toe Dertormed under this permit-check all appy:
HVAC Gas Tank []Gas Piping _Shutters ❑Windows/Doors
❑Electric ❑ Plumbing Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 2,700 Utilities: Ll Sewer[]Septic Building Height:
W
011jNER/LESS r ,� CONTRACTOR � � �
Name KtAU Qrec_ n Name: C '�I.UY M
Address: 5-9 — 1 &r-n lwi it' Company: Cie' (k k
City: State: Address�:t"190 )8� OAC- c�(p43 L
Zip Code: �3 ���- Fax: City: � �r State: (=l1
Phone No. 'r7-1-1-c3J 9 - Zip Code: Fax:71o�
E-Mail: Phone No. 7 701- -��'" 1151
Fill in fee simple Title Holder on next page(if different E-MaiC`j-- gbe.IISflne f
-from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
I S NM"'� x.,e'a'xo £ rt Y
5UFFLEMENALCONSTRUCTIt3N LIEN lAWINF
ORMATIQ(U 3
'5-
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: V 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 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 r recoLding your Notice of Commencement.
Signature of Owner/Lessee/Contractor as gent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA P STATE OF FLORIDA
-
COUNTY OF_J1n()l.Cr k YJ COUNTY OFri
The for ping instrument was acknowledged before me The for Ing instrument was acknowledged before me
this, day of f q.20 'by this ay of ,b 20� by
n,B-'I Gt,
Name of person making statement Name of person making statement
Personally Known_�OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(.Signature of Notary PuAc,-;STate,of Florida) (Si nature of Nota
DIANE K BOND ;:�►"" DIANE K BOND
"= MY� ISSION#FF1f3543o Commission No. = Y COMMI �I#FFta543o
Commission No. p:
'9'......., :�Y:
EXPIRES December 28,2018 `
••.,,,,.,, -•,�...-..•-�.' EXPIRES December 28,2018
(407)390.0163 FI9rldaNata orvlcoxom "�F'�
.. . . (407)39"153 Floridallota Service.com
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17