HomeMy WebLinkAboutBuilding Permit Application ALL APPLIC BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ,
Date: Permit Number. UO
' RECEIVED
Building Permit Application AUG 2 8 2018
Planning and Development Services 5T. Lucie County, Permitting
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: To Select from dropbox, click arrow at the end of line
,PROPOSED.IMPROUEM.ENT LOCATION,
Address: �P ca\ G 1�
Legal Description: -Takl C 2 GS A T GAS— L4(l= /5 Al.9 99 LF1 97
CM A2 s344 21,:95) (E)11,3-1 LQ
Property Tax ID#:340a &ID 0559' UU0 9 Lot No. C9-7
Site Plan Name: T107TA Q I ZI\/ewe_ Ccc�(r4--T tS Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION:OF WORK::`
1 n&tQ 1 I i vJ I Ice)` C)_ L4 - + a m i n k FeXnLc and
D(Ic 6` and ons S )Izxub ie-- sc�4-,,,--
L31 d1e
CON5TRUCTION INFORMATION „ . . �. �_` _
Additional work to be nerformed under this permit-check all appy:
HVAC Gas Tank E]Gas PipingShutters Q Windows/Doors
13 Electric Plumbing Sprinklers []Generator C!Roof Roof pitch
Total Sq.Ft of Construction: I1CQ1 Sq.Ft.of First Floor:
U
Cost of Construction:$ Utilities: Sewer 0 Septic Building Height:
OWNER/LESSEE CONTRACTOR
r.
NameSH CE? FLY M LI Name: P'lan�
Address: Company: 1-t (��An I;��r �-7_
City: Fbe1 . ?t:iZCv ` P�'MSVa9-� Address: Ia5
Zip Code:U4gg Fax: City: Favk• i-erc P Stater
Phone No. 7 - '?i�—59� � Zip Code: 3q 4 SLO Fax:
E-Mail: Phone No.-77a—c950 - Ll'(07
Fill in fee simple Title Holder on next page(if different E-Mail: Q�,uo V,J4
from the owner listed above) State or County License: OLP S'L(4
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION: .
DESIGNER ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: __._Not Applicable BONDING COMPANY: _„_Not Applicable
Name: Name:
Address: Address:
City: City.
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the Issuance of a permit.
St.L.cie County makes no representation that is granting a ermit v�rill authorize the permit holder to build the subject structure
which Is in conflict with anY ppiicable Home Owners Assoca#on rules,bylaws or and covenants that may restrlctor ppprohibit such
structure.Please consult wit�i your Home-Owners Association and review your deed for any restrictions which ma a ly.
in consideration of the granting of this requested permit,i do hereby agree that 1 will,in all aspects,perform the work
in accordance with the approved pians,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 morns 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 your Notice of Commencement.
s
Si ature of owner/Lessee/Contractor as Agent for Owner Slgn ure of Contractor/License Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF_ L(,lC' COUNTY OF cQ
The for oing instrument was acknowledged before me The forgoing Instrument was acknowledged before me
this 111 day of AtA01,G . 20 LS—'by osis Q day of A U Cnr20 i g by
(Name of person ackno ledging) (Name of person acknow)edging}
(Signature of Not=OR
of Florida) (Signature of Notary Public-State of Florida}
Personally Knownduced Identification Personally Known �Produced identification_
Type of Identification Produced Type of Identification Produced
Commission No. C��(rn> 097 (Seal) Commission No. Qn(�' DWI)O47 (Seal)
Revised 07/15/ '.H,�Y `: GABRIELLE HICKS ,gt;Y'Pyy y GABRIELLE HICKS
MY COMMISSION#GG 069047 :;: MY COMMISSION#GG 069047
REVIEWS f'04, Nataty .'y� ' X-PIR-9:61 Few
,'R5V.a TIVU NMY Public
PLANS V OVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS