HomeMy WebLinkAboutBuilding Permit Application t
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q
Date: Permit Number/Ew
to r �
Building Permit Application
Planning and Development Services APR 19 2018
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 Pe rm i ttiDe a r
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Res deIf
tme
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
F r
PROPOSED INIPROVEMEIT LOCATIC3N zr. b
r.,..
.,,
Address: 7.8 Me A erraoee,i Ped J1 flare„ Fe-All Z
Legal Description: 31. 664, 6666.1 26 ,76 YO 84XS I OAR I-Y6 Ely OF 03 &/ 12/41-Leff Neil
E5 JW g461 (US DIST ;A orS 2VIT-MO:25'yY-2V(3: 207-15ZZ: Z10J217 : zS�,�-zJ48•-•
Property Tax ID#: 7 f'501 - 1701--OQo -1 Lot No.
Site Plan Name: rr Block No.
Project Name: W;dd+M3k� IrQroor
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
.
►►out otgd rtPlq� �oo�`
CQNSTRUCTIQN' 'NFORMATIO , r
Additionalwork toe performed un er t is permit-check a appy:
HVAC Ei Gas Tank E]Gas Piping _Shutters a Windows/Doors
Electric ElPlumbingSprinklers E Generator VM Roof Roof pitch
Total Sq. Ft of Construction: e160 S Ft.of First Floor: �p
Cost of Construction:$ 6�$7a Utilities:li Sewer E]Septic Building Height: 1.21
OWNER%LESSEE COt�I"RACTOR
Name Name: t /I O
Address: �8 .Med-PeP�'q�A 8114 F Company: MECAQ kfA W14 I[o "S„Thr
City:_P64 S{, Lot E State:L Address:,?L20 JTV A✓ C1
Zip Code: Fax: City: PJM C44 State: F4
Phone No. (M) 70 -521) Zip Code: JMO Fax: (�72��1'0700
E-Mail: Phone No. f772 7el-0100
Fill in fee simple Title Holder on next page(if different E-Mail: (UA roor4s &tUA-ha '
from the Owner listed above) State or County License: CCC
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTkUCT10N LIEN LAW INF4RMATIflN
M MORTGAGE COMPANY: _Not
DESIGNER/ENGINEER: Not Applicable
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.
a_ z��L — -41 -..
Signature of Owner/Lessee ontractor as Agent for Owner Signatu Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5i L0('v_L- COUNTY OF {MA P(—O
The f9Tgoing instrument was acknowledged before me The forgoing instru ent was acknowledged before me
this day of ��t2T.L 20� by this_Q day of tP2 20A by
CAS V�'1T`2 �• �1;� ��/� �. �.l��S�-(
Name of perso making statement Name of perso making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(( ignaturie f Notary timnat e o -;s+?i. ,• J S MORSEJAMES MORSE
m ' Sion No. .` MYCOf��ON#GG 14W
ission a' ISSION#d§q*U
Ti,
row; EXPIRES:November 3,2021 ei.
EXPIRES:November 3,2021
'v-.FL�Q� Bonded ThN Not�I Pub0aUndwvwi6�s ''FOF °: Bonded Thru Notary Pu6GcUndelwr�ets
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17