HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �J`�41 `� Permit Number: ��d�J 0553
RECEIVED
+� MAR 2 0 2018
Building Permit Applica 'LQn
�T. Lucie County, Permitting
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:
ROV9WT
Address: / 70 7 L?e_X k e_NS zfdl 1 ori" �t G_� /-L. -7411 �t l
Legal Description: fir✓9�` vi lAt g4k -2 4ot.Y_ a-v,/2 I/
n a AC o►- 3460 o�f
Property Tax ID#: #��/D� ` Dy "040 g Doo �S Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WOR
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itiona work to be pe orme 4uneir this permit–check all that appy:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _ Plumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: SOS - Sq. Ft. of First Floor:
Cost of Construction: $ ,? ys`0• y� Utilities: —Sewer —Septic Building Height:
ER LES =
MEEK
Name e�.`��/d c.•b�era Fl eXd Name:
Address: / 707 j3,;,kreAAs fld. Company:
City: 1--or-f- 1'f crc,e State:J Address:
Zip Code: -? '1'7V7 Fax: City: State:
LFillin
No. 7 7 Z - 416 S - Z Q 0 Z Zip Code: Fax:
G ook�e1a�.✓/t G�xakao. C oi+n Phone No
ee simple Title Holder on nextpage ( if different E-Mail
e Owner listed above) State or County License
f construction 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:
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.
Signat rebTOwner/Lessee/Contra cto as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledg before me The forgoing instrument was acknowledged before me
this day of Mot 20 N' by this day of 20_ by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary P lic-State of Florida ) (Signature of Notary Public-State of Florida )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identific tion Type of Identification
ProdMNR IFUNENS Produced
NAr0023
MY COMtASS10N#G 16 2020
Commission No. Q'v :� P1�Ss: Ello�nde�rles Commission No. (Seal)
'O� ed ThtuNotzN p'
�•F OF i���F Bond
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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