HomeMy WebLinkAboutBuilding Permit Application 1•
ALL APPLICABLE INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED -1
Date: '�� Permit Number:
. ,
"-A;_ .,= j RECEIVED
0
Building Permit ApplicationJUS 2 6 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PRbPOSEb-IMPROVEMENT LOCATION: 1
Address: 45b �r OPI gal �- �� C\rc�Li �' 4o
Legal Description: (D V\_� 441D
Property Tax ID#: "Y�� iJ�� "' f�aa�- o Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED,DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit-check all appy:
HVAC Gas Tank 0Gas Piping _Shutters Q Windows/Doors
Electric ❑ Plumbing O Sprinklers Generator ) Roof Roof pitch
Total Sq. Ft of Constructio � � S . Ft.of First Floor:
Cost of Construction:$ R&<-01) Utilities:InSewer 0 Septic Building Height:
OWN'ERAESSEE: CONTRACTOR;
Name--T�:OQSe kSIrS t�o- ons Name: 3)'0 C_-r LAY ort
Address: a`b _700161:m_ 1��cs C' Company �'11�nG W ►' �'C�,e �vl�
City: F4�i e c'GC� State: Address: gyp\ Ss►.dPg �/P�
Zip Code: '�t�`6 Fax: City: F+C��,11 e SGP- State:
Phone No. Zip Code: 649yp Fax: U A-
E-Mail: Phone No. 5 LPI 'x"7{4- 9'61 S
Fill in fee simple Title Holder on next page(if different E-Mail-ty io 9-wrc-IiI r>r\I'Aeraryuv-�d i tiAd-
from the Owner listed above) State or County License: ,0n%S !�)
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: hone:t Zip: P one:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phon Zip: Phone:
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 fir . spection. If you intend to obtain financing, cons I h lender or an attorney before
commen ' widrk or reco;ding your Notice of Commenceme
s
ature o ssee/Contractor as Agent for Ownerignature of tr c r L cense o der
STATE OF FLORID STATE LORID
COUNTY OF `tiaA C 1 COUNTY OF
The forgoing instru ent was acknowledged b fore me The forgoing instrument was acknowledged before me
this day of �LtJ L 20 acknowledged
this day of 20 by
C=r n
ame of p ackn I gi (Name of p n a wle ing)
l
(Signature of ry ubb c- to of Florida) Signat 're f t ry P bli Stat'of Florida)
sonally Kn < R Produced Identifica 'on P own OR Produced Idenation
Type o entification Produced Type of Identification Produced
C j n o. (Seal) Commission No. r° �P&" DEBORAH RAF�g�1TNEI(
mmissim# 1 298
z°t�`;;°�% D RAE COURTNEY `o< Ex fres June 15,2021
Com ssion"GG1152AR OF f16'
c� Expires June 15,2021
Revi 7/1 / jFOF moa Owded nw Budget Notary Swm
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS -T