HomeMy WebLinkAboutBuilding Permit Application 06/06/2018 08:00 Lindquist Plumbine 7724611999 1,10.612 #002
ALLAPPLICABLE INFF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED d
Date: G Permit Number:
Q RECEIVED
Building Permit Application
Plonning ond Development Services JUN 0 7 2018
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 ST. Lucie COUr_1ty, Permitting
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Resp en la
T APPLICATION FOR: elect from dropbox click arrow at the end of line
(y(�. �//�rlt iy] 1�a1,/wa(��{-(y C{�f {� �} (T}yo S It pI
i'A..40POSEUJI IPRO Y I MEN T.:l•4( �l.I.
Address: 1 `� �l —
Pill
Legal Description: �
A c�- IDT �( --/�L` ��1s��y�}1 a-���,�� fls �xZ -► t,./(31� A0_
Property Tax ID#i:Q� 1_�D b !-W!S O,�.LJy-� ���Fl&X B d,
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
�t� �^T •x ry::i.w y.:':w: nh,� 4 v-. .,. u.. .ri. r 'y r a r ,..
w.ri�i -._ :..t.r. r , rv^�utitiwvnuv... i n .R, pie w� '.t.•�."u;.�sud .., 4 a n
r
P Ln W oAr L i ne-
�l
4� �� 1 �:1fQ1�RY4JT(U�l. M< im4r�tru4z :,_: h lzrvv481; 4Gk24u3 ��szwnuJ va.,.,.
Additional work to b rformed uiclertMis permit-check apply;
HVAC Gas Tank E]Gas Piping Shutters Windows/Doors
Electric ❑Plumbing Sprinklers L1 Generator Roof Roof pitch
Total Sq. Ft of Construction: _..., S Ft.of First Floor:.
Cost of Construction:$ �_i �QLj Utilities. L Sewer 5eptic Building Height:
L
Name Name:
Address: C1 Company: '
City: -c- —State:_ Address: G
Zip Code 5ffl5a es
Fax: . City:t"T (P f(C� _. ____Stater
Phone No.3'1 3p pd Zip Code.-SLA Fa-uLwal-1
E-Mailfti aylnt C,h''L1nd.g56rDC1Vd5,JU Phone No'-)-]
in fee simple Title Holder on next page(if different E-Mail: ,kr4 l _ �)W k i A 1
from the Owner listed above) State or County License' at
If value of construction Is$2500 or more,a RECGRDED Notice of Commencement is required.
06/07/2018 13:56 Lindquist Plumbing 7724611999 N0.620 8002
SUPPLEMENTAL CONSTRUCTION (AFN (AW INFORMATION
ME[VTAL COQ
u
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 CO'MRANY: Not Applicable
Name: Name:
Address: Address:
City: City.
Zip: Phone- Zip: Phone:
OWNER CONTRACTOR AFFIDVIT:Application is hereby made to obtain,.a permit to clothe 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 thq�is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any,applicable,Home.Qwners 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 underguing a Full cuncurrency review:ruom additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and aceessory 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,pasted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencinR work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of.Contractor/License Halder
STATE OF FLORIDA STATE OF FLORIDA �f
COUNTY OF _�7 P ( %� COUNTY OF r
The forging instru nL was acknuwledged erore me The for oing instrTmnt wasacknowledged before me
this day of 20 by this.dayofnE'. 20,R by
1 6LJe- Lsc_ 4 L t-
Nama of pprson making statement Name of person making statement
Personally Known L -OR Produced.identification Personally Known„X,,•_,OR Produced Identification
Type of Identification Type of Identification,
Produced Produced
1
(Sig at re of Notary
/rPublic-State of lorida) (Sign tur of Notary Pu lic-State of F i
Commission No. � - WCQ�M�lI�171078 Commission No. A(rIn4
�N 1!ti0171t1TS
tr ; E> D6aember 27,2071 = ky EXPIRM oewnrber 27,2021
wW UNWO errs ?�f. 6o�aad mu r+mn ardro uweer.er n
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW RFVIFW RFVIFW
DATIE
RECEIVED
DATE
COMPLETED
Rev.8/2/17