HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q
Date: 1 I G 1 l Permit Number: �A �1 0L, 13
.�' RECEIVED
y JUL 1 9 .'018
j Building Permit Applie #Rnie County, Permitting
Planning and Development Services
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: \ d0
FR4P®SED INPR®VEI�I'ENT LOCATIQN: G
Address: 550 Paurn+is LiuPP R Pierce ., EL310MZ
Legal Description: Rx FJ ((Ace, e)C i` S-ti(yQ door- (A) i �In �rwylL� 5 i ze qL7
Property Tax I #: 3y10 - .'03-C9C)0 - -7 Lot No. Z
Site Plan Name: Block No. I
Project Name:
Setbacks Front Back: Right Side: Left Side:
DET ILED110IIPTIO,NOF WORK:
)GY14- J 0LAU/'l (-Lri (c.-cc cloc) Cf x 14r,c, c G-,c.d'c, donz-
Additional work to be peffo—rmed 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: /, 6_C7C), [1-O Sq. Ft. of First Floor:
Cost of Construction:$ Utilities: —Sewer —Septic Building Height:
F_MIA LE=�SSEE: CONi'RA ®R:
NameIy i f(i cwn A e Name:
Address: SSCP LAJ Company: i4- Tech Cmc rc.�� cJoc,✓ /
City: Ff Ae-rLe- State:_f-C- Address: c186V-iuw-AJor-(6.
Zip Code: 3 yQA 7_ Fax: City: /S L State: FL
Phone No. Zip Code: 7gQRT Fax:-
E-Mail: Phone No 77
Fill in fee simple Title Holder on next page(if different E-Mail ¢ecG.4c,✓k�zG1x,( s 4 M.0 L c'o�
from the Owner listed above) State or County License Zfa2-fs 36Ss
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
VS F00 M 08,01, CON5TR�UCT1aN Li N LAW INFORMAT CSN:
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: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT: Application is hereby made fo 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 thepermit 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 4_0r. COUNTY OF
The forgoing instrument was acknowledge before me The forgoing instrument was acknowledge before me
this °\ day of:3*0\y ,20 n by thisA' day of 2XI by
Z. SSaC QOt�� C_ �aCict.
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced L L Produced t'
(Signature of Notaryubli tai q"Fioridgtial+r,rrRPJIARIt"" }• --
VdG,•,, v,tGGo 2023 (Signature of Nota Pub[7j' Staxg.of Florid 104Na�ARIEGNENs'
h1Y bs,41S,29�� �S jl t; MiYCOMFAfS510N#GGlir20"/_z
e CO{��11SS10
Commission No. dsdl'„ t' 5��� u:G�cem Unden°niters IN ��j t{ {`p sai ,g�mbati8,?_Q20
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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DATE
COMPLETED
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