HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �' �' ( � Permit Number: ` U
RECEIVED
• - --
Building Permit Applicati n APR 0 3 2018
I ST. 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: �1�G V
D INPROV
Address: 2602 J� rLiz s+ T:Qtj ?ISL lLc PL_ 3 LM q
Legal Description: (� ��CT71 t�Lt �L alt t,�C= C�a.0!s'6-
Property Tax ID#: Qz=i i.((on l• >D�' QUU ' Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: — - _ J
STR
ltmonal work to be pertormed under 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: Sq. Ft. of First Floor:
Cost of Construction: $ l� ��0 . Utilities: —Sewer —Septic Building Height:
Name ZU CA t 7G era Name: O l Gismo
Address: Company: (E�It C G
City: — i State:FL Address: 1
Zip Code: Fax: City: O aT- S'� (U dE State:_T__L
Phone No. )-I !q ql7 401 3 Zip Code: 34 ctr3 Fax:
E-Mail: Phone No rma) 3L0_C?4
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Fill in fee simple Title Holder on next page ( if different E-Mail E 1V6,et d►i 1 n °� C� �A �• �CIz1
from the Owner listed above) State or County License 'Fr_ /3 0495 3
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
NSTR' ENL N:
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 inspeFKn. If you intend to obtain financing, consult with lender or an attorney before
commencing workpryedqrding your Notice of Commencement.
Signature o Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Loa, COUNTY OF
The f cling instr ment was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20a by this day of 20_ by
(Name of person acknowledging) (Name of person acknowledging)
KA EN S. NIELSEN
Comr fission AFF 115637
ll
(Signature of Notary Public-State of Florida ) L o Jolq#Nota Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
KAREN S. NIEL EN
Commission No. _` 9al�ommission# FF 1 5x69 ssion No. (Seal)
f' f-
My Commission Ex fires
June 12, 2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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