HomeMy WebLinkAboutBuilding Permit Application I
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r Q
Date: Permit Number:
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RECEIVED
Building Permit Application FEB 2 0 2018
Planning and.DevelopmentServices permitting Depadmell
Building and Code Regulation Division St.Lucie County
2300-Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential r _
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PERMIT APPLICATION FOR:
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Property Tax ID#• 30 6 0 6 0-3 Lot No.
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Site Plan Name: Block No.
Project Name:
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Setbacks Front Back: Right Side: Left Side:
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rtiona vvor to a pe rme un er t is permit-c ec a at app y: I �,
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—Mechanical —Gas Tank —Gas Piping —Shutters _Windows/Doors
Electric Plumbing —Sprinklers —Generator ,a _Roof Pitch
Total Sq.Ft of Construction: �� Sq.Ft.of First Floor:
Cost of Construction:$ ��^�d Utilities: _Sewer- _Septic Building Height:
:3:_ i __..a..-'_cv,..._-_..:-:: '' • £'s. ..•,.—:xnx:..- ', _..x:5• F�am�-t.S_� ...+r. :t mer - n:�'¢9-'."ts..� .�` Fv'Y i �`-- -� a,; -r�.�,y'^k,�.u.`E_''Ssk3 ,Y..e,.�"v.r.`�ii„'.'MS, 10,
Name e ti�4 , Adv-- c
Name. f 1�r GI
Address: O z: ti Company: ;'Cc& rev IJP4 W i1M,
City: 1 State:' `�- Address: d
ZipCode• q1 . Fax: Alflt City: F f State: (-
Phone No. Zip Code: 3 4f i Fax: 27-2- 4//o to S�i
E-Mail: Phone No
Fill in fee simple Title Holder on next page(If different E-Mail GCf0_1 �i�llrij
from the Owner listed above) State or Cou License S
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I�value of construction is 2560 or more,a RECORDED Notice of Commencement is,requireil.
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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: i' Not Applicable
Name: Name:
Address: Address:
City.- City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permifto 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 hereb$agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County A;mendm i nts.
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
commewng work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Sig ature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S COUNTY OF ZyJ%kAtc.e,
The forgoing inst ument was acknowledged before me The forgoing instrument was:'acknowledged before me
this o1'1 day of 2011 by this day of .20/ by
(Name of person acknowledging) (Name of person acknowledging)!
A'%.-A,
a re of Notary Public-State of Florida) (Signature of Notary Public'State, f Florida)
Personally Known ORP oduced,ldentificati_ Personally Known ',OR Produced Identification
Type of Identification ��•,, LASHAHNA INGRAJd,a Type of Identification
Produced o�ra Notary Public-state of produced '�— -MyComm.Expires Dec 21 �,�Z"611
LASHAHNA INGRAMCommission No. ="�9o; C ion#FF 177j2�` cta!g,jJ -State of Florida.
Q }f Commission No. &'•��,,,,,.•�• Bondedthfough National Not _•. y Co m.E Aires Dec 20,2018Commission#FF 177249
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION; SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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