HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: (P- )-7 Permit Number:
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Building Permit Applic tion JUN 112018
Planning and Development Services
Building and Code Regulation Division Perlllittll' g Depa]E-D
2300 Virginia Avenue,Fort Pierce FL 34982 st, Lucie county,
Phone: (772)462-1553 Fax: (772)462-1578 Commercial R i-a-l--
PERMIT APPLICATION FOR:
PROPOSED lNPROUEMENT MMO O'
Address: iOtitO :9 OCP-ci-i br. ''--100-7 , 0�NSe"i
Legal Description: �(u4c ►SNS'0'0 C` o --Ao-r l o0l
0n 33-7-'+ t aS: ga37 - a�t�
Property Tax I#: 451/ - !j - 0o-79 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: N�,q- Right Side: _Left Side: N I
�J
DETAILED DE�SCRIPTION OF 1NORIC: n
a2ur o 1,A, coi d�o � eti dq*'le<) 1 4.50 e>
CONSTRUCTI N INFORMATION:
Additional work to b, -pertormed under this permit!-.ChecK all that a.pp y:..
_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 Constructio000 Utilities: I/�ewer _Septid.... Building Height: 4,2001
PROPER.
Name ChrS 3 U "f- Name: !^i5 e(IeAdd.V
Address: ��9 �l�y�G��C �j: Company: r,, S-�eve,4o,)�lW , ,ft,-7�(�-
City: P,"OP- . State: Address: (7�n9 ��Cyl�i�-rlc �l�/! . �j� l�/ !0q,
Zip Code: 3`�� Z Fax: City: F-f,� P�Ace- State:,
Phone No. 2A S--- -7/0 ( Zip Code: 3`}JigOL Fax:
E-Mail: Phone No ?7Z-Z95- 7l09
Fill in fee simple Title Holder on next page(if different E-Mail CA) p "&W-
from the Owner listed above) State or County License C 3c 03:5-os
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL. «®NS�TR�t1CTtON I.I�N LAW I'Ni-CJR�MATIO�N.
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: Da(2 a,,I Lind a ca Name:
Address: P;,le T,-e.e br-; Address: n
City: G—i a—o V'A a, City:
Zip: &W7 Phone: 51!y—Z-73— 0,C;-.86 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 toncing, consult with lender or an attorney before
commencingwork or recordingour Notice f ncement.
Signature o wner/Lessee/Contractor as Agent fo Signature of Contr for/License Holder L
-ooc c
STATE OF FLORIDA o �C STATE OF FLORID
COUNTY OF o m COUNTY OF
ti �T'U
The forgoing instr as ack owledged fore g Ny m The for oing instr a s'acknowledged imp
fore
this�ay of 20 y CD this day of 20 y
i^ i sl— isrlq
Name of person making statement. Name of person making statement.
Personally wn OR Produced Identification Personally Known OR Produced Identification
Type of Identifi tion Type of Identi
Produced `ic� Produced
?�ai '
(Signature of Notar u lic-State of Florida V (Signature of Notary blit-State of Florida)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/11