HomeMy WebLinkAboutBuilding Permit Application ALLAPPIJCA13LE INFO MUST BEoom PLETID FORAPPLICA110N TO BEACCIFTM
Date: !`� -- '/ Permit Numb
RECEIVED
•
Building Permit Application JUN 2 6 2018
Planning and Development SNvioes
Building and GbdeftulationDivision Permitting Department
2300 Virginia Avenue,Fort Reroe 8..34982 C I e FL
Phone: (772)462-1553 Fax (772)462-1578 Commerd al t 11 n ty,
PQMITAPPIJCATION FOR To Select from dropbox, click arrow at the end of line
PROPO®I All PROVEM BVT LOCATI ON. .,
Address 'Lf O C.A, ��-
Legal Description:
Property Tax I # ���I J-� - O Lfl - �j Lot No.
Ste Plan Name. Block No.
Project Name:
Setbacks Front Back: fight 9de: Left 9de:
L*LAIO DE,IPION OF WORK
� 3 it 115 7 S H Z
DONSTRUC110N INFOf�1AATION:
i ion wor o e orm under ispermit- appy:
HVAC _Gas Tank ❑Gas Piping _9iutters ❑.Windows/Doors
_Bectric ❑Plumbing ❑8prinklers ❑Generator ❑Fbof Roof pitch
Total E31.R of Obnstruction: 8R.of First Roor:
Cost of(bnstruction: $ 2 �-/b� Utilities Saler 0 Sbptic Building Height:
,� oWNB�r L QDNTPAQ7Q
Name Name;
Address q O 9 1V (ompany: —nic IAC')l n a
City: j,r-k Q ,-n-I-- Loec g Sate:[-L Address 9
Zip Code: c/ Fax City: �` s; C-C- ,c-
gate:�L
Phone No. s 3 -2-` �9,; Zp de:,-3 44J-3 Fax 7`u• u q- =
0
E-Mail: Phone No. '71-- t�n - /,f✓�. I-'
FII in fee simple Title Holder on next page(if different E-Mail:C oc�(�:-,G ��.-,. .�a.--.r_��.�,t�..�:L - a•�
from the Owner listed above) Sate or County Lioense: C- c- t
If value of construction is$2500 or more,a fEOOFUED Notice of Commencement is required.
_ !a
SJPR DEME VTALOONSIRUC110N L1BV LAW INFORMA110N:
DE9GNERENGINEER Not Applicable MORTGAGEOOMPANY: Not Applicable
Name: Name:
Address: Address:
Qty: Sate: Qty: Sate:
Zip: Phone ZIp: Phone:
FEES M PLETITLE HOLDER Not Applicable BONDINGOOMPANY: Not Applicable
Name: Name:
Address: Address
Qty: (sty:
75 p: Phone: op: Phone:
OWNER OONTRACTORAFF!MAT 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(Dounty makes no representation that is granting apermit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home OwnersAssoaation rules,bylaws or and covenantsthat may,restrict or prohibit such
structure.Pease 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(bdesand St.alae(bunty 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 usesto another non-residential use
WARM NGTO OWNER Your failure to Ford a Notice of Oommencement may result in your paying twice for
improvementsto 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.
gnat Owner/Lessee/(bntractor asAgent for Owner Sign ure of Contractor/License Holder
STATE OF FLOR DA STATEOF FLORI DA
OOUNTY OF OOUNTY OF
The 4going instrument was acknowledged before me The for ing instrument was acknowledged before me
thiday of :]j2-a C 201A. by thisday of L2018 by
Name of person making statement Name of person making statement
Personally Known ORP-oduced Identification Personally Known X. ORPtoduoed Identification
Type ofldentificati n HeadwTio Type of Identification
Heed Tb
Produced NOTARY PUBLIC Produced PUBLIC
STATE OF FLORIM k IXTASTATE OF FLORIDA
Cantu#FF19M CortFF192528
J�Q ' n 1 42 ° Wires 1/251201 e es
(Signature o otary blic-State of Rorida) (Signature of Notary Public-State o onda
Commission No. (Sam) Commission No. t� l (Sam)
ti
FEMENIS FRONT ZONING 9JPERASOR PLANS VMUAMON SEATURRE MANGROVE
COUNTER REM EVV REVIEW REVIEW R BA W REMB/V REVIEW
DATE
RECEIVED
DATE
COM R =THS
Rev.8/2117