HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q '
Date: Permit Number:
RECEIVED
Building Permit Application APR 04 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION: w
Address: (� > ( •)� l �3lSl. IZ �I ` :� Cf Z
Legal Description: _2% 7 .//{:�)/y
Property Tax ID#:��`T - (4 i b — 0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: c7 J Left Side:
DETAILED DESCRIPTION OF WORK:
00b PST LJ4
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit-check ail that appy:
_Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors
Electric _ Plumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ /906) Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Name: 11 L C , .a5Z3��
Address: Y'oi Compan � 0L ,yVIC `pz')('�
City: State:� Address: `
Zip Code�-,_� Fax: City:Y3 Y1 Stater
Phone No. 7-7 .2— _ Q6 f0:5'7 Zip Code: Fax:'7'7,�
E-Mail: Phone No
Fill in fee simple Title Holder on next page ( if different E-Mail ac)q'u`S rC2nCt'i4&§) Q/2 0't F
from the Owner listed above) State or County License 9.7; -7
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTIO [.I�
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.
Signatur Owner/Lessee/Contractor as Agent for Owner Sign ure of Contractor/Liceof er
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrum nt was acknowledg?F,,before me The fyr oing instru nt was acknowledge before me
this day of 20JA by this ` . day of 20 f by
r
(Name of personedging I (Name of erson ack ow dgin
G
(Sign ture of Notar Public-State Florida ) ( nature of Ni6tary Public-State o Florida)
Personally Known OR Produced Identification V/ Personally Known OR Produced Identification
Type of Identif'Lation Type of Identification
Produced 11li— _ _ roduced
,•;.R KAREN S. NIELSEN
Commission No. Cq l¢s'on 4i FF 115u3/ ommission No.
nary/ o(/�nMission Expirestom nission �SEh!
June 12, 2018 s;E, F,.= MYComm,ss'on
FF 1156._%
Ju e 12. 2018 s
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
�ev. 7/201
GO gle Maps 5808 Raintree Trail
Image capture: y 011 ®2018 Google
Fort Pierce,Florida
P. Google,Inc. RECEIVED
Street View-May 2011 APR 0 4 2018
ST. Lucie County, Permitting
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- PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building&Code Regulations Division
-- ---All 2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982-5652
(772)462-1553 RECEIVED
FILLED LAND AFFIDAVIT APR 0 4 2018
ST. Lucte Count
Y, Permitting
I,the undersigned, am the owner of the following described property, J
Ply'OPE,e%Y .i Z2. -(/'/U-- O/lv /-O OD `�hF�3�E//S✓ o�
.z- 4j2,L C &S7;9 'Es - .V.7- 9- B'e ?���o��� ( gam/
(Pared IM Legal descriptlWAddress) &7-bOg 4/lV T-e C-
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for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number , I acknowledge
that as owner of the above described property, and in accordance with Section
7.04.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring
adequate drainage so that the immediate community WILL NOT be adversely affected.
I further acknowledge that in granting this permit for the development of this property,
St. Lucie County is neither obliged nor liable to provide for, or maintain in any form,
adequate drainage off my property which will not adversely affect the immediate
community.
7�9'-n C /-'Q (Ili 2-l,/d C
Owner Name Print)
Property Owner Signature Date
STATE OF FLORIDA,COUNTY OF �-K r'-—X2
ACKN WLEDGE]D BEFORE ME THIS DAY OF — 20
BY Q M IQ �►'(�L�� WHO IS PERSONALLY KNOWN TO ME(El OR WHO HAS
PRODUCED CC AS IDENTIFICATION. r
SIGNATURE OF i TAR LIC TYPE OR PR
23_
COMMISSION NUMBER
, SANDYCROGHAN
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