HomeMy WebLinkAboutBuilding Permit Application i
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: .'". Va.: \‘at Permit Number:
ojmmiminuiimimmh RECEIVED
IL -R-CievaitE. -- : -
4Cca_i INTY , . MAR 2 3 2018
F L 0 FL 1 D FL -- ---
Building Permit ApplicatiqPie County, Permitting
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 17.
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential i
PERMIT APPLICATION FOR: V,cct.c. _ ,
P'OPOSBD I P ® EIVIW L.0 CATIONg ' r r •
Address: 7V/ 1/2C/&--S'e- i'L/i flep'2-Ys f//7- i,
Legal Description: Al ,y), / --k" 1.l':.‘144- 414-49 i;146/ 3 2-
?2 1/9 5"/21, fz .P1 tr-1/0 Ff./744eif qe, 04)6.27-47/he ?)`is-L
Property Tax ID#: /3/ll —MI,4)/12Y—a5-0—/ Lot No.
Site Plan Name: hitt a-aa/7;(// Block No.
Project Name:
Setbacks Front Back: Right Side: LeftSide:
1E- @IP @ ff WO°IC.
A---,e,(96,1 i itaITA M el/ 6'a,w-.e_ /e)Od
ireeigwe a-#a.yAil ,, 45744, 0,14-4-/i , t 1/-r-4 ../i/it‘ 4 6,4
4fd, /eieb,e,red .-/ (1416.-Xdiewe-A, et/4/ ig 1,4
,
so , TD CTION INFORIVIA ON;
Additional work to be performed under this permit--check all that apply:
— ____
Mechanical Gas Tank Gas Piping Shutters Windows/Doors
_
Electric Plumbing _Sprinklers Generator lkoof 42.
_ _
Total Sq. Ft of Construction: cyp- Sq. Ft.of First Floor:
[
Cost of Construction:$ /fe a Utilities: _Sewer _Septic Building Height:
/
0 WILLS-96e- , , - €ONTR 4 MR?,
Name /IN i d- is7i Name: 1#free, 4 ,,IX
Address: ' ' 44 ' tr. / 'e-- Company: Qilie‘ lki-il -, ,p, 1
City: c 4te,e State: 1- Address: r,..9 i&.41--0 -/ /fle
Zip Code: 7 Y157 Fax: City: Jr:, A4tesece State: n_
Phone No. 772 -267--4f3 Zip Code: gVec Fax: 272-2 0.---i2_,-9
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E-Mail: Phone No (' /2---2-10/--424Y
Fill in fee simple Title Holder on next page(if different E-Mail 5;4/le, -, P 4,7„; 6-:/--1
from the Owner listed above) State or County License ede .0:05-4,•6'
If value of construction Is 2500 or more,a RECORDED Notice of Commencement is required.
S` ?'PL v1;4\1'130611,. €® S RUST 0 ( AY2) Rkini I ON • , ' ,
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 subje�ct�fructure
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 your Notice of Commencement.
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Signature of Owner/Lessee/Agent Signature of Contractor/License Molder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF , 1-VC\e COUNTY OF . k- c.`‘.
The fqlgoing instrument was acknowleOW before me The forgoing instrument was acknowledge before me
thisl 't day of \A e ,2OV by thisda.) day of `S'V`r`' 'C ,20 \\ by
'Ka\nc k 6vs,'.�'1r 10 icj t.iC-\• Sri- -\7Yl
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Pu c-State of Florida) (Signature of Notary blic-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identific tion Type of Identification
Produced ' L- OE_ Produced L O—
.-:. �� _
Commission No. IC� 1�- Commission No —�
o-a <<,r----D,1-JkviNi\f'.....,,A0R,411:4...Gd(ViEcji212Sr,23` r �i� A�N��1�.FS � 'f�NSi :? 1�1tO �,41G ), {: hiY COMMISSION ft GG D22023.
n.:.rnksr,,2O i, (, '':'-,0:,c4 !FARES Flecrmoer 96,2020 g
'.0 o`,Ii. Bond d Thai Flotc y Public Uric env,'" 1tf o ?or c d Th a troll'nc Pupl.c t r:uerr riirr. It)
REVIEWS FROw1VT ZQ�IJGG- :.-St7PT jSOf ' PLANS VEGETATI&N f-A71 'FLr NGROVE
COU `EER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ley.7/2014