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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: `�-;L&I Permit Number: /96 7— O 6,
f -
3 RECEIVED
Building Permit Application JUL 2 4 2018
Planning and Development Services ST, Lucie County, Permitting
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:
PR©-PO-9Ed 11N�PROVEME-ANT LO A I:ON:
Address: 5700 64L.54M 43k.
Legal Description: SjvY6t6- F'✓ MsL_+<
Property Tax ID#: -' �D�D ' �.C�U `-1 Lot No.
Site Plan Name: Block No. T7
Project Name: TD?L1VEW4
Setbacks Front Back: Right Side: Left Side:
DETA);LED Df�SCRIPTI N OF W®RK
FGuNlvuQ-- A Z21t>LwAY —114A-T- will L'O,y,W C- 'Ty Ex�ST1N'E� ��Iw Wx►Y-
/y"rE21w>A. M►ial P2yP�ld,TY r,�P br4f.�T� r�y n✓a�Tl-4 �S� C3F �Gb
�t8 'e- /LISA U' 1000 Psi' �2�x ADS
CQNSTRUC� 1®N I�NFQ1iMATl® _:
Additional work to be pertormed under this permit-cF-e-ER all that appy:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of,Construction:_AP,Qey Sq. Ft. of First Floor:
Cost of Construction:$ �2/00 Utilities: —.Sewer —Septic Building Height:
01iVNER/6 US�SEE: MMS TRACTOR,
Name //p.AVZ'-e �. (Y)Ax►.CC--LL Name:-- ,
Address: 5"70:5- t )/'ALS✓�rn DR• Coman -
p Y
City: FoA•T P1t=ver_1 State: r-L Address:
Zip Code: 3 4 9 j?9- Fax: />A- City: State:
Phone No. 0.72) 5'1'1- -z1oe) Zip Code: Fax:
E-Mail: Phone No
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.
SUPPLEMENTAL CON5TMION LIEN LAW INFORMATION:
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 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
commencin , ork re or in yo- Notice of Commencement.
Signature of ner/ essee/� tractor as Agent for Owner Signature of Contractor/License Holder -
STATE OF FLORIDA`r STATE OF FLORIDA
COUNTY OF ,C(/c/� COUNTY OF
The�fo,r,�oing instru ept was acknowledge efore me The forgoing instrument was acknowledged before me
this day of J rI 20 f' by this day of 20_ by
okgmL fflftWPAr
Name of pers n making statement. Name of person making statement.
Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification
Type of Identifation Type of Identification
Produced L Produced
L l�
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Commission No. w1w,T— KAR I NIELSE N Commission No. (Seal)
tear rye
?:° ���State of Florida-Notary Public
_. .=_ rrimmisgion
" , My Cornmis ion Expires
REVIEWS F e PLANS VEGETATION SEATURTLE MANGROVE
Col KtVlt-VV— REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 8/2/17
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