HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: `b a Permit Number:
Y`
RECEIVED
s r '
_ Building Permit Applica ionAUG 0 2 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County; Permitting
4-
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR:
PR� `®SED )N • ROUEM � T LOCATION:
Address: La S Lvs,6 D S
Legal Description:
Property Tax I D#: ���1 A 5 d' 4 y 0 4 - dC'5 d 1 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DE�SCRIPTiON � F OR�K
CYC e
5-7Q5
C0 STRUCT(ON INFORM TION: 41 ,
it1-5-5-5-1 work to be performed uncler t is permit c ec a tat appy:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: /JSq. Ft. of First Floor:
Cost of Construction:$ 0 (2)t Utilities: —Sewer —Septic Building Height:
011U'N�ERJLE=�S�SEE: CONTUaTL@'
Name Name:' % Zo`v-y
Address: Company: '
City: `Q State:, Address: L4 0'X._. L5 K-! c
Zip Code: 7 5:Z Fax: City: p State:—
Phone
tate:Phone No. 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 7500 or more,a RECORDED Notice of Commencement is required.
S °PPLEMENTAL MTO LI N LAW I FO. MATIfJN:
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 dr 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
comme0qng work or recording our Notice of Commencement.
Sign re of Owner/Les ntractor as Agent for Owner Signature Contractor/License H
ATE OF FLORIDA ST E OF FLORIA
COUNTY OF Sk. COUNTY OF
The forgoing instrument was acknowledgegbefore me The forgoing instrument was acknowledgeq before me
this�. day ofy 20� by this az of V t ,20A& by
� .o:� ,,,� �'�-�,.� 1�. ��a �d1►.,,. �.�Zz a cam,���
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 Ident'ficationn
Produced L fl C- Produced �-
(Signature of Notary P blit-State of F (Signature of otdt blit-Si r a22o23
DEANNAM�IE G1V p023 :a°''�• MY COM bet 16 2020
Commission No. #GG :; � FtES:Decem •tars
�MYCOMflmbet16,2020tere Commission N s. NotaryPublt(g
SPIRES a publicUnderHn F;?'F;;.•`'
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REVIEWS FRIII;* ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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RECEIVED
DATE _-
COMPLETED
eV.
8/2/17