HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l� q
Date: y a Permit Number:
RECEIVED
APR 24 2018
Building Permit Application aeCounty, 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 4�
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION: NJ
Address: 5,1794.1.1 '-r1P,
Y� ey e a 9 Y 9 Y q
OW-4A �c.eS
Legal Description: � d cewP,, 'Q � �[ 63 ,b!f f
Property Tax ID#: 1Yl0 -612 -669N- 600 -1 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional 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: $ G QQ� Utilities: —Sewer —Septic Building Height: 10 PY
OWNER/LESSEE: CONTRACTOR:
Name t1le'um cXw MANY Name:
Address: 1`tl_ 12&&104y rb Company:
City: MOWMA✓-t State: Address:, �
_ L"4L, AVY
Zip Code: 3oQz 3 Fax: City: Fd ;),&Le, State:
Phone No. 756 W6 gZ1.3k Zip Code: 2419Y Fax:
E-Mail: Ix1�j�.S�w /F� (14, Aid Phone No 1772 975�
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.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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 cp.venants 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 grantirrg 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:doom 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 wi lender or an attorney before
com enci work orrecording our Notice of Commencemen .
Sig ture of 0 ner/ Contractor as Agent for Owner Signa of Contr'actor7license older,
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5t , COUNTY OF L �.�
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 7,3 day of c\' l 20_& by this2,3 day of r. ` 20 (' by
4�4.
(Name person acknowledging) (Name o person a knowledging)
•
(Signatu.re of Notary Public tate of Florida ) (Signature of Notary Public-State of Florida)
Personally K '" ' tification Personally Kno R Pr diced Identification
Type of Id ' �� Type of Id
Garwood
Produce (\ Produced
Bonded thru Aaron �� January 16,2022
;,u,,,� t ) o�' Bonded thru Aaron Nom)
Commission d. ���( Commission N6.�,,,,,,,,��
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 712014