HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: k. Permit Number:
Fn
ECEIVED
•
Building Permit ApplicatiR 02 2018
Planning and Development Services ST. Lucie County Permitting
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: O�
O �/ /
Address: 01 " e,�S'� 3.144 "l �v
Legal Description: ISVS `�� UZ —vim
Property Tax ID#: t � Z - cook 00 � -- OC3a - l Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front_-_ __ _ Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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r— 0 1'V U (o— d Z .
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Additional wor to e per orme under this permit—check all that apply:
_Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors
_ Electric _ Plumbing _Sprinklers _Generator /Roof Z. Pitch
Total Sq. Ft of Construction: $'OZ Sq. Ft. of First Floor:
Cost of Construction: Utilities: —Sewer feeptic Building Height:
..OWNER/LES § ,E:]_
Name °M (( Name: O
Address: Company: t7s
City: 'CCr_i State: Address: 7Z-7o(,
Zip Code: G Fax: City: State: (,
Phone No.7XZ Gl (-\- 1-4 1 CA Zip Code:3 ,4 A 1 Fax:
E-Mail: Phone No_717, 61'TS— A l ;)
Fill in fee simple Title Holder on next page ( if different E-Mail
from the Owner listed above) State or County License
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRU Ur FUR
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMA Y: Not Applicable
Name: Name:
Address: Address:
City: ate: City: State:
Zip: Phon 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, c nsult with lender or an attorney before
com ncing vWork or recording our Notice of Commenceme t.
Signat Wf Owner/Le a/Contra or as Agent for Owner Signat a of Contractor/Li rise Holder
ST E OF FLORIDA ISTATE OF FLORIDA
COUNTY OF f U[.i.� COUNTY OF
The for oing instrument w s acknowledged before me The for oing instru nt wa acknowledge before me
this .L day of VV'Gy 20 by this day of 20 Ub by
L 1 ov '' M
Name of erson making statement. Name of erson making statement.
Personally Known V OR Produced Identification Personally Known /--- OR Produced Identification
Type of Identification Type of Identification
Produced Produced...
�F; m�yn Garwood
Commission#GG175422
,`'�������',. Kirrherlyn M. ' Expires:January 16,2022
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(Sig fQ*u f _ rjr"wdss>M$tGC47M&rida ) (Sign `o - e orida)
2022
Com b r n 1 p ry (Seal) Commission No. 66 1S (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17