HomeMy WebLinkAboutBuilding Permit Application 4
Aug 06 2018 1:06PM HP Fax page 2
ALL APPLICA LE INFO MUST BE COMPLETED FOR APPLICATIONI TO BE ACCEPTED
Date: N Permit Number.
FA
EIVED
Building Permit.Appl.lcatio 0 7 2018
Planningand eveldpment Services ounty, Permitting
Building and de Regulation Division
2300 Virginia venue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT AP ILICATION FOR: 'To Selectfrom dropbox, click arrow at the end of line ✓
Address: P
Legal Descripti n: i' r t e-C T 4J,2 01r
PropertyTaxl #: 30�, '/aL7 �yC3 — Odd Lot No.
Site Plan Name; Block No.
Project-Name-
Setbacks
roject Name:Setbacks F nt Back: Right Side: Left Side:
oV" arv0, .3 acv :4r
dQcJ r+► ry 3-L )9 1 )9
Ow c�-
at
itfona woto a orme un er is perm -c ec a app y: 1
HVAC FIGas Tank Gas Piping _Shutters Windows/Doors
Electric Plumbing Sprinklers E]Generator El Roof Roof pitch
Total Sq.Ft of nstruction: Sq. Ft.of First Floor:
Cost of Constru tion:$' 1000. Utilities: F Septic Building Height:
Name tIV arr Name:
Address: ! c: 2f Company:
City: T r2 State: 7 Address: r '04k
�.
Zip Code Fax: City e_ Stater
Phone No._,;?j ft� — 4( Zip44
Code: 3 f PA Fax:9Jl..?- 1-7
E-Mail: Phone No. CJ L G"
Fill in fee simpli i Title Bolder on next page(if different E-Mail: 0
from the Owner listed above) State or County License: 4
ifvalue.of constri iction is$2500 or more,a RECORDED Notice of Commencement is required.
Aug 06 2018 1:06PM HP Fax Page 3
NNEI 00
DESIGNER NGINEER:. Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip; Phone;
FEE SIMPLE TITLEHOLDER: _Nat Applicable BONDING COMPANY: —Not Applicable
Name; Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone.,
OWNER/CO TRACTOR AFFIDMT:Application is hereby made to obtain a permit to do the work and Installation as Indicated.
1 certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie unty makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is inCocon l ct with any applicable Horne Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Pleas consult with your Nome Owners Association and review your Gleed 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 th the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The following bt ilding permit applications are exempt from undergoing a full concurrency review:room additions,
accessory struct ires,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TC I OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvemen to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the fir;t inspection. If you intend to obtain financing,consult with lender or an attorney before
commencing York or recording our Notice of Commencement.
i
Signature of 01 Yner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OFF RID STATE OF FLORIDA 1 ►
COUNTY011 C:' / COUNTY OF
The for oing I stru %entwas acknowledged before me The forgoing instrument was ackn wledged before me
th is day f H, _ ck — 209 by this-,d— .4 day of ` V 20 by
�
Name of person making statement Name of person making statement
PersonallyKnown J OR Produced Identification Personally Known OR Produced Identification
Type of Iden Type of Identification
Produced :`' •. GARYOH Produced
Nota
fy Public-State of Florida �.,,��+��u,,• PATRICIA A.GARYQN
'• . My Comm.Expires Ocl 23,20113 `"pY�;�s Notary P blit-5tate of Florida`
Y,y� ..
i
(Signature o aryAssn. (Signature o - or `c-SIO l°I8 )
13 Jbtlu
..,.,,•` Bonded Thrcugh National Notary Assn.,
Commission No. (Seal) Commission ° "'"�` " Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev, 8/2/17