HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 Permit Number:
(--RECEIVED
Uncel
Building Permit Applicati n MAR 16 2018
Planning and Development Se-vic s ST. Lucie County, Permittlil
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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 'r-\t Mcg
PROPOSED
/IMPROVEMENT LOCATION: �1 r p
Address: I J O S �n rtt �A t-Td N f7 t>I E 1' n /Z-f- I ; s`.2C Ir �L 3 4- '?,5-
Legal Description:
Property Tax ID#: rO + \� d 3 Lot No.
Site Plan Name: Block No. 6 -7
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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ICE ICE
[CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit—check all appy:
HVAC Gas Tank Gas Piping _Shutters a Windows/Doors
OElectric ❑ Plumbing L J Sprinklers 11 Generator F� Roof Roof pitch
Total Sq. Ft of Construction:_rSq. Ft. of First Floor:
Cost of Construction: $ l�7 0 Utilities: Sewer[]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name �f)C(A J �A S oTIollS i-�c Name: PF-TE7R 8Ro01G5
Address: 441 q til '~)K _ `t- S,,'Te ,tl 7 Company:PFT:E2 C�2v o/CS I
City: Hi c deo'_' State:�L Address: Z6a L AILQ Co NSJAAl cE 1)2; VE
Zip Code: 3-3012- Fax: I-f5h t5 635 170 City: W I° f3 State:_,P
T
Phone No. 305 33b 1 661 Zip Code: 3 3 4 I I Fax:
E-Mail: Corn Phone No. 56 ( .S-73 2.6 27
j Fill in fee simple Trtie Holder on next page(if different E-Mail:
' from the Owner listed above) State or County �icense: r— C /36o 6 —17 7
i
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _^Jot Applicable
Name: Name:
Address: Address:
Citv: 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: I 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 ccnsideration 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
commendrip,work ol recording our Notice of Commencement.
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Signatu 8 Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S.-Q,t a on t >ekA+G to U ak'� COUNTY OF :r->f}t4y' l-�
The for oing instrum nt wa acknowledged before me The forgoing instrument was acknowledged before me
this day of � 20�by this day of Fg�S A-t�/ ,20 /9- by
loo-K) e - CDL) i (co 7- 1�
Name of person making statement Name of person making statement
Personally Known OR Produced Identification `� Personally Known OR Produced Identification ✓_
Type of Idntification Type of Identification
Produced7( Producedjt - _t) i+ceIS CA«_4-C
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v
(Signature of Notary Public-Stale f Flori�(LQUZAAAN (Signature of Notary Public-Stat e►f"61p,�rida tANDRA ALICASTRO
S *My COMMISSION#FF 979528
Commission No. QRY PUBLIC �^
`4 $ 11`` OF FLORIDA Commission No. N �t (�OhES;May 27,2020
l Comm#GGIS8830 �'av��°'A"ded TMu Budget Notary
'Expires 1911712071
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED _
Rev. 8/2/17