HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / U �r
Date: 8h 5 he Permit Numb Itis _
AUG 5 2018
ittir� Department
Building Permit Appli
Planning and Development Services fit: Lucie County, FL
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:
PROPOSED INPR®UEMENT L®'C• ISN:
Address: 175"- SE F r e s is A r-
Legal Description: R enla u_ J rn r- 9 X 7
Property Tax ID#: 3 4 lu - S3O -O l 6S- dOd - - Lot No. /Y
Site Plan Name: Block No.
Project Name:
Setbacks Front I/ Back: Right Side: Left Side:
DETA LED DE�SCR'1 'TION OF WORK:
E�GDIGlt. 2s�!SY,'.vG X7
doInr co z--��t /IIIIIGc S Ae.v"C_ er,6r 9.17
CONSTRUCTION INFORM I®N:
Additional work to be pertormed uncler this permit-check a t at.app y:
Mechanical. Gas Tank Gas Piping _Shutters _Windows/Doors
Electric Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction: $ 8576. 66 Utilities: —Sewer _Septic Building Height:
• a a aONTR 0'R:
OWNER/LESSEE: .
Name 4 j GAi J I ve Name: 12,;'R L Ao r•; a
Address: ?/?I- St,) &,111a42s 01 Company: A -Teck Ekxrc�ge Ancor
City: State: TC Address:1196c1-XJ _j_A1 Aza /Moet'
Zip Code:zy4s Fax: City: /psi Stater
Phone No. Zip Code: T,Y03 Fax:
E-Mail: W"//('a07 Phone No '772-&z -S-42/
Fill in fee simple Title Holder on next page(if different E-Mail Aleck 90,r<5e- dc3or
from the Owner listed above) State or County License
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
t
SIJPF'LE�/IENTAL CC?NSTFtl1'CTION LIEN LAW INFC?RMATIDN:
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: TNot 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.
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 exemptfrom 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.
-�.�•c,� .�. �---rte_ n��zc��,
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder a .
STATE OF FLORIDA :''• '* STATE OF FLORID �°'a*`
COUNTY OF COUNTY OF 03
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The f rgoing instru nt was acknowledged befo a e The forgoing instru t was acknowledged
this day of 20�by rop c this,./ day of 20� nv�--,'�
a mom' d �
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cf�P3
J .R11�tR
(Name of person acknowledging) G P:9 p (Name of person acknowledging)
(Signature of Not Public-State of Florida ) Signature of Nota ublic-State of Florida )
Personally Known�..OR Produced Identification Personally Known OR Produced Identification
Type of Identificatiotl pti Type of Identificati�
Produced Produced �(
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.