HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED -�
Date: '�o� J�. Permit Number: f
Building Permit Application
Planning and Development Services FEB 12 2018
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:
PR60'dSED:,INPROVEME,NT LQCATION .
Address: L_a e- " P tol
w8e cLe. tS(
Legal Description: Lul&1,14o,nd PCIil3 flK-2I oL 42`14P 13 L45DlL �27_
Property Tax ID#: 13 Q[- 66),3- 6)r` O-- 000-I Lot No. 02
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION C3F WORK
-Fru, o44- l n,y ,.g I re4 t7,:o&e i-ool
CONSTRucTiO:N INFORMATION
itiona work to be performed under this permit-c ec a tat appy:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
/
_Electric _Plumbing _Sprinklers _Generator Root Pitch
Total Sq. Ft of Construction: 1,-7 Sq. Ft. of First Floor: j 3V
Cost of Construction: $ 7 Oub Utilities: —Sewer _Septic Building Height:
OWNER LESSEE
U
M
ONTRACTOR -
Name !'..t YJ4J1iix (!!2l4vn HIP Name: OJ 1, UlL 1824-1 Y
Address: 7C? Lei -t 6 1.d W&..,/ Company: S U n r 1 '5Y e_(f,/ G Db
City: to,if r-e t,- �/ State: Address:
311f,6-1
Zip Code: 31f9 � Fax: City: [' (( 9,fe re.e_ State: ry
Phone No. '772-521- 021,, 3 Zip Code: L(&1 L/ 7 Fax:
E-Mail: Phone No 7 7, -.2,91- ,?,Q�U
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License 04 L 13 Z 72-08
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
FFF-S't1PPLEII/IENTAL CONSTRUCTION LIEN LAW IN ORIVlATlO"N--
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 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 work or recording our Notice of Commencement.
`2�
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forging instrument was acknowledged before me
this day of 20_ by this�day of r 6 ,2011 by
(Name of person acknowledging) (Nam of person acknowledging)
(Signature of Notary Public-State of Florida) nature of Notary Public-State of Florida )
Personally Known OR Produced Identification Personally Known OProduced Identification
Type of Identification Type of Identification
Produced Produced
apt.*. P.B!'f+ J0 i1Wi 3R
Commission No. (Seal) Commission No. * MYC #FF21M
N„ EXPIRES:Jui 18,2019
9T P�
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 7/2014