HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: - I Permit Number:,
J IL-; _- I�� �� RECEIVED
Building Permit Application APR 3 0 2018
Planning and Development Services
Building and Code Regulation Division
ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential 6�
PERMIT APPLICATION FOR:
(PROPOSED IMPROVEMENT LOCATION:
Address: 8 ,'ye r OAK L ,1„ /
Ao /^:'e�,�� l�L 3 Y9 RA
Legal Description: ,V.O-ir O Z L
CO . 7_-7 AC ) e,r 3kG9- 951q,
Property Tax ID#: sZ 4 30 - 0 Z. - ("_)b �'^f - b!� C9 Z- Lot No.
Site Plan Name: A pA C-ked� f a—LAz6, dv
, Block No.
Project Name: - [5D♦"^-qj 91"Pi's �ra.✓yt�o 7
Setbacks Front c Back: ' Right Side: Z U ” 6' Left Side: I �? 3
DETAILED DESCRIPTION OF WORK:
nerd ed Z EL D Yw R L335ci -R
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 f/Roof Pitch
Total Sq. Ft of Construction:30100 Sq. Ft. of First Floor:
Cost of Construction: $ /d� QOM Utilities: _Sewer _Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name ,,, �"�`,.,r , Z Name:
Address: ,1S R iw'er (9/4 r LAN Company:
City: ''f /�i.�LC State: /_L Address:
Zip Code: 3 ys 1 Fax: /t.-1A City: State:
Phone No. 7 7 2 3 3 2-3 Zoo &iZ ql0-34 Zip Code: Fax:
E-Mail: ; ,'ne &ISrf( Phone No
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 CONSTRUCTION LIEN LAW INFORMATION: —�
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 inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
_Z4-) . � 5
Signature oO
fwner/Lesse ntractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIP4 STATE OF FLORIDA
COUNTY OF LU..c COUNTY OF
The forgoing instrument was cknowledged before me The forgoing instrument was acknowledged before me
this day of 20_4by this day of 20_ by
(Name of persona cknowl in (Name of person acknowledging)
KIT,
1l r
(Sig ature of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
�;;r •••,, MARIVEL LUNA
Commission No. CommiftFF903183 Commission No. (Seal)
-�= Expires October 2,2019
''+� � Bsbd TMu Tny Fain Miws+m Bpp�BL7019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 7/2014