HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE,ACCEPTED
Date: �— A ! Permit Number:
r X RECEIVED
. r.. w _ _ Building Permit Application APR -92018
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue,Fort Pierce FL 34982 St. LUCI OU nty, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Re
PERMIT APPLICATION FOR: /
PR`OPQS.ED iNRROVEMENT,LOCATION r R
Address: 107)5- S• Oce4✓l 9t. 3 Jeo rne,4,c 4 FL 3y fi 7
Legal Description:. &)Jav W G V L vc,P Lvlll- D 5 b
J
Property Tax ID#`. 11- 5-02 "000,?-600 Lot No. 2
Site Plan Name: 6/0//64 Oaf Block No. Al
Project Name: -36
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION CIF WORK
C Orr1Afle/Tmok," ,'0,1 ah rePnaV i' O� y2yX70C j*?oAe Ankde 4isI
t 190",-"'X YO ON7.
CONSTRUGTIQN INFORMATION
Additional work to be performed 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: 41,)- Sq. Ft.of First Floor: y� y
Cost of Construction:$. /900.06, Utilities: ewer _Septic Building Height: f
OW'N" ER LESSEE. 4
CONTRACTOR
_ a.
, s �.
Name Weirrerl �,)0�in L• �rr-OS✓e,94/ Name:
Address: :0 130X .2/91 Company: ��N, ��,;��� �or�cG74 lvr • �h�•
City: BC 4 tL,j- State:)01 Address: dd/ 41,Z7 ewee.-
Zip Code: yy0 y5 Fax: City: Ter,Se» gegcZ State:FL
Phone No. y31d-11L Zip Code: 3yY7 7 Fax: 772'2
E-Mail: Phone No 772" Me) 771T
Fill in fee simple Title Holder on next page(if.different E-Mail 2�a in Srn% i ae 0 �/dAo • CAI*?
from the Owner listed above) State or County License CBC/,2 57/9J1l
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION'LIEN LAW INFORIVIATtON
/ pp MORTGAGE COMPANY: _ Not Applicable
DESIGNER ENGINEER: Not A licable
,Name:-. Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Not Applicable BONDING COMPANY
_ _ _ pp 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 thepermit 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 recordin r Notice of Commencement.
Signatu a of Owner/Lessee/Contractor as Agent fo Dwner t Signature of Contractor/License Holder
N <
STATE OF FLORID A STATE OF FLORIDA ,� _
LU
_,� _� _ _
COUNTY OF f/t/C.C,Q. � COUNTY OF iA
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The forgoing ins'tr ent was acknowledged before zW g The fo oing instr dent was acknowledged efor r W g
this day of 20 by oa this day of .GL 20.M 3�
QX -2 ¢}X
s �w m
b
(Name of person acknowledging) e4 (Name of person acknowledging) e;
&_n
•SuB• ,
(Signature of 66tary Public- tate of Florida (Signature of No r Public-State of FI a ) .
Personally Known OR Produced Identification Personally Known` OR Produced Identification
Type of Identification Type of Identification
Produced Produced
Commission No. (Seal) Commission No: (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION . SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 7/2014