HomeMy WebLinkAboutBuilding Permit Application May 07 2018 11:11AM HP Fax page
L APPLICA LE 1 FO MUST BE COMPLETED FOR APPLICATI N DBEACCEPTED
ate: Permit Number: 2
RECEIVED --
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Building Perm pplication MAY 0 7 2018
lonning and evelopmentServices
uilding and ode Regulation Division i ST. Lucie County, Permitting
300 Virginia venue, Fort Pierce FL 34982
hone:(772 462-1553 Fax: (772)462-1578 Comme ci I Residential
P RMIT A PLICATION FOR: To Select from dropb lick arrow at the end of line
Ac�dress: S 0
Le al Descript on: G.
Pr perty Tax I 4: 0 — 0032 -000 ' Lot No.
Site Plan Nam Block No.
Project Name:
5 tbacks Fr nt Back: Right Side: Left Side:
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RP, 0eve, 3 +a iv C s 5 G �e or i e
XO Rt )936j9z5-) N )9 9, H -36J? Seer
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itiona wo to b e rformed un er t is permit—c ec a appy:
HVAC Gas Tank ❑Gas Piping Shutters Windows/Doors
Electric Plumbing Sprinklers L Generator Roof Roof pitch
TolaI Sq. Ft of onstruction: /S 00 S F f First Floor:
Co t of Constr ction: $ 10�/ Utilities: ewer Septic Building Height:
Na e G r� S p� S
Ad cess:
-)-'FV 4 C rn any: r t ary 0
Cit yr �c/cr State:� A d s: ,S /cs S F vet O+� ►'
Zi Code: Fax: C y: r P rr'c Stater
Ph ne No. — i1 ' — V5 Z Fax: i),?— rS0 —60/ I3
E- ail: _ P or i No.
Fill in feesimp a Title Holder on next page(if different E r CN
a �l"v c, �' T� on
Own r listed above) j1--A
, �a ►+�
fro the OS t r County License: L'AC /��•s—x/.51
If v lue of const uction is$2500 or more,a RECORDED Notice of Co i cement is required.
May 07 2018 11:11 AM HP Fax page 4
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ESIGNE NGINEER: _Not Applicable O , GAGE COMPANY: _ Not Applicable
ame:
ddress: ss:
ity: State: t State:
ip: Phone p: Phone:
EE SIMP TITLE HOLDER: Not Applicable ING COMPANY: Not Applicable
ame:
ddress: d ss:
ity: y
ip: Phone: Phone:
01 NNERI CO TRACTOR AFFIDVIT: Application is hereby mad to tain a permit to do the work and installation as indicated.
I rtify that n work or installation has commenced prior to the iss n of a permit.
St.Lucie Coun makes no representation that isgranting a permit I a horize the permit holder to build the subject structure
w ich is in con Ict with any applicable Horne Owners Association rul s, laws or and covenants that may restrict or prohibit such
str lure.Pleas consult with your Home Owners Association and re Ie our deed for any restrictions which may apply.
In nsideratio of the granting of this requested permit,I do hereb g that I will,in all respects,perform the work
in ccordance ith the approved plans,the Florida Building Codes a S Lucie County Amendments.
Th following b ilding permit applications are exempt from undergo g ull concurrency review:room additions,
ac essory strut ures,swimming pools,fences,walls,signs,screen ro nd accessory uses to another non-residential use
W RNING T OWNER:Your failure to Record a Notice of C m encement may result in your paying twice for
i provemen s to your property. A Notice of Commence must be recorded and posted on the jobsite
before the fi t inspection. If you intend to obtain financi , insult with lender or an attorney before
commencing ork or recordingour Notice of Commenc t.
5 gnature of 0 ner/Lessee/ ontractor as Agent for Owner 5 n re of Contractor/License Holder
S ATE OF F ORIDA A OF FLORIDA
LINTY OF TY OF S L in r t e—
e for oing i strument was acknowledged before me T ping instrument was acknowledged before me
t
is
f M q 20JA by t s day of r1j-1 „�_20f& by
n r3 +S
Nam of person making statement Name of person making statement
P I's 11 Kn wn��_OR Produced Identification P s Ily Known ?_OR Produced Identification
T pe of Identi cation T e Identification
P oduced
PATRICIA A.GARYON
PATRICIA A GARYON +° Notary Public•State of Florida
NotarViiblic• of Florida 1� •''- MY C m, Expi cl 13,20113
( ignatud dub i� qf,$1cF044k ( gn u o7' L1f )Pt $ f4Assn.
Eonded The v h Naticna:Notar Assn,
C
mmissIrMI sion No. (Seal)
EVIEWS FRONT ZONING SUPERVISOR A VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW R I REVIEW REVIEW REVIEW
0 TE
RECEIVED
DTE
C MPLETED
Rev 1
8/2/17