HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ' C� Permit Number:
;k � f , RECEIVEDNI -
�. s. _
AUG 14 2018
Building Permit Applicatio ST. Lucie County, Permitting
Planning and Development Services
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:'����
PRQP05€D'==1NF'ROVEMENT LOCATIQ1 h 3� s _ s x{
Address: 87D5'a 60o-r4 /IJd 1AAJ RiVM 4DAlye )CyaT i1 teRey 'cL 5 6}8 Z
Legal Description:TM OSA(L, P F?-VP81z7"Y- PrN VWZYCOP-P rb P(A r- a-rS 1 14yud Z
t/y& ECY OP e Rw F CC R g Gess N D k I id hie r 001z 315-69 V7so
Property Tax ID#: 0 Z' 0001 " 00 C) -10 Lot No.
Site Plan Name: Block No.
Project Name: K.(,0/eJ G V Y G'r CO T rA 6r 6-
Setbacks Front �D°1 . Z Back:_T004op°Right Side:9,!r,9 LeftSide: e2b 3 D
ti• / fi4
•'�u _tkx x�s,s �.t c�a.. t.FrE.. : —..1• ��� 5' .�. � � a,x -4...t
PPra-rm-L 1>6/n�-O . �D 1Ajc to a_, Ga�77l2!/ 490 .41,(- FlMr,(4
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Additional work to be pertormed under this permit-check'all that appy:
:._Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors'
Electric Plumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: , �� "Sq. Ft. of First Floor: a e) Sql r
Cost of Construction: $ 1006 Utilities: —Sewer -Septic Building Height:
001,1-,4 - .
OWNER/LESSEE ti r x , CONTRACTOR
fns ,_,. �`� * 'u t �,. �'�..�e a � `�.n_ '.. �; sc� �xr_,. a;!"_-
Name X0 OJ N/V 5 XC 0110 jr 0R16/T !t 9. A1140 kh ame: NN1 6P. ...
Address:A?09u 50d 7171 1;)DM)A) R//02 OR Company: OW A)h'Z •'103111 C-0 67Z
City: AD 9-7- P((M eW State:r Address:.
Zip Code: 34-9,9 Z Fax: City: State:
Phone No.1`77 2) (,99 �t 4 3 Zip Code: Fax:
E-Mail:t24 uAJ 1 d KI d/W 4 V G)Wl41L -1 Cowl 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.
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�-UPPLEM�NTAL CONSTi UCTIflN A1N 1NFflRNiATI ;'
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m a
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: P A v L W VGC J4 '10 C Name:
Address: 10104. 6.yJ . S I CI P4•DXV ST 1.4 Address:
City: 'O 2 "f, COC-1E State: L City: State:
Zip: 344 f4:: Phone 972 - 9 AM Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _XNot Applicable
Name: J`&m e .45 4W tu 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 thepermit 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
WARNIWtingy1oX
ER•Your ilure to Record a Notice of Commencement may result in your paying twice for
improvmrerding
rty. A Notice of Commencement must be recorded and posted on the jobsite
before you intend to obtain financing, consult with lender or an attorney before
commeour Notice of Commencement.
Si ature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA. Y
COUNTY OF COUNTY OF
The forgoing instru ent was acknowl'edgeA before me The forgoing instrument was acknowledged before me
this day of 20by this day of 20_ by
Ir&0.*VA)Iff
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification
Type of Ide ation f Identification
Produced rl. KAREN S. NIELSE d ced
;State of'Florida-Notary Puc
mmitsion # GG 20 484
Commission No. ;��gear' (Seal)
y commission i�eom i'sslon,No.
�,OF* June 12,
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Te—v. 712-014