HomeMy WebLinkAboutBuilding Permit Application r
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: U' Permit Nu fir:
Building Permit Applicati n AUG 2 7 2018
Planning and Development Services PeF � ��� D�� i' f'enlr
Building and Code Regulation Division _
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie COUP;` � FL
Phone:(772)462-1553 Fax:(772)462-1578 Commercial ReSI'Te la
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
-PRO.POSEDIMPROVEMENT LOCATION:
Address:_LO
Legal Description: r(�-20 C_t0 P,r-Occ
r�r~ v2
Men -2- 40�r-�—
Property Tax lD#: .1�Q( ) 1 ( _ D10 '71 - ()C)L", Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION.OF-WORK: _
CONSTRUCTION INFORMATION: _
Additional workto en`ej orme under this permit-check a appy:
0HVAC 11 Gas Tank ❑Gas Piping _Shutters F]Windows/Doors
Electric �Plumbing Sprinklers I Generator 2-Roof Roof pitch
Total Sq. Ft of Construction: /S& �� So. Ft.of First Floor:
Cost of Construction:$ 16Z t;_O Utilities: Sewer Septic Building Height:
OWNERAESSEE: 'CONTRACTOR:
Name ��rm Ah �-EZ�(�Ql CV-Do Name: � F�
Address: vim' e, \,t1 4p, Company: Y
City: r="F P? ere_-o State: Address: 01 v ' .rev'
Ky-
Zip Cade; - ;j Fax: City: Et h eiz_P State: F/
Phone No. `i^l a- 4(Aa_ `dam o Zip Code:.,E3 4Q I R Fax:
E-Mail: Phone No. 5(a( - 6-714 -qq 1 `b
Fill in fee simple Title Holder on next page(if different E-Mail-'Raj b
from the Owner listed above) State or County License: 06(v_ m)+ .? �
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
FName:
PPLEMENTAL'CONSTRU ION.LIE N-LAW INFORMATION:,,. '.
SIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
_ Name:
Address: ' Address:
City: State: City State:
Zip: P one. Zip: PhWe:
FEE SIMPLE TITLE HOLDER: !Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: _ City:
Zip: P o e: —.... Zip: o
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 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,l 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
improveme s 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, con ith lender or an attorney before
comme cin work opl ecording your Notice of Comm enceme .
s
Signature f O er Lessee/contractor as Agent for Owner 041fiatur of tr ctor/License Holder
STATE OF FLORIDASTATE OF FLORIDA
COUNTY OF Lu rr COUNTY OF - 1 �
The forgoing instrument was ac nowledged before me The forgoing instrument was acknowledged before me
this day of_ U 20
[Lb, thisa�_day of—AtkaCtLA _,20 by
r
e r on acknowledging) A" ,
�° ' * (Name of pe now(e g)
19 /
(Signat re k]N tary lorida) (Sig re of Nota P Ii Stat of F orida) * .
o
Pers y Known ed Identifica � ersonally Kno ro ced Identificaf o
Type of Identification7LXd Type i ication Produced
Commission (Seal !� Commission (Seal)
�vised�7 /2/14
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS