HomeMy WebLinkAboutDriveway All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
� 7J.
— •w{ RECENED
• JUN ?, 9010
Building Permit Application
PE'ftr►itdnp DgAmrtmen
Planning and Development Services St. Lucie co„n«,
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR:
Address: C� T -30?-051-
Legal Description: P6t.r vnY 51D C 0 `7 (0.1q ae ),yr, F,2 L/5p3,)S-T41 c/S /e,
Property Tax ID#: �c,? '-/�-D &0 t/ 000V 4000 Lot No._�
Site Plan Name: "Dkvl S Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTIO OF bRK
Additional work to be pertormed under this permit–check all that appy:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _ Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: 5 Sq. Ft. of First Floor:
Cost of Construction: $ y 7,5r Utilities: —Sewer _Septic Building Height:
Name Name: (�/
Address: 02 qD(o 5- 34 SIS Company: -DAN1
City: Svc_ State: 1z Address: / sD tse Dr
Zip Code: 3 49P/ Fax: City: 7 State:��j
Phone No. Zip Code: 3 Fax: 7
E-Mail: Phone No 7? z Z-a 3 7 d'
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.
7DIESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name:
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.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA - STATE OF FLORIDA -
COUNTY OF : • LU CCOUNTY OF SI— . L
The forgoing instrument was acknowledged before me The forgo�i g instrument was acknowledged before me
this ;2S day of JOAe 20 If by thisaSS day of Jyn V_- 20�IS- by
GL)I 11 5 ek— , l�� �1•
(Name of person acknowledging) (Name of person acknowledging)
�_�LX� J Z A au- \'_ Jw c_'A� OnC LA—)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida )
Personally Known-----I OR Produced Identification Personally Known OR Produced Identification
Type of Identificatioi Type of Identification
Produced :�i'' KARYN G DRAWDY Produced a DRAWDY
•: Mx COMMISSION#FF198558
Commission No.� � COMMISSION
11.2019 Commission No. G MMI S #FF 198558
14C7 ";ao1s3 Fl,r;e.Nou. sa"Ka,w,, ., ,, EX IRES ate ry 11.2019
14C7:'•1"153 nor4*Natvy$wvre,cw
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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