HomeMy WebLinkAboutBuilding Permit Application ALL.APPUCABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED c?01' X°,1
Date: ai . )T Permit Number.
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Building Permit Application AUG 3 1 2018
Planning and Development Services
ttrilding and Code Regulation Division Permitting Department •
2300 Virginia Avenue,Fort Pierce FL 34982 •
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Resid%itiailcieS1 FL
unty
.PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PRORPOPIt:
Address: (.12 51
LegalDiscription:„SerrizSle- Fctr Lot 1r '5 •
Property Tax ID#: 110C-S(Xt-OQ042-000-3 Lot No. R
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Site Plan Name: Block No. S
Project Name: Ca C.42 t.
Setbacks front Bacic Right Side: Left Side:
DTALCRIp3JON OF WORK
C410- -Ou
•
;*PON:414000.)Sts --01,PRMATIPN:-;-,* _.• _
Additional work to bp_pLertormed underthis permit-check all flagc apply:
01-rfAC LJ Gas Tank Das Piping LJ Shutters arVindows/Dtj04
Electric D Plumbing jSprinklers 0 Generator Roof
Total Sq.Ft of Construction:
of First Floor:
Costof Construction:$ f co g Utilities:U Sewer Ej Septic Building Height:
Name 1..dni..ore...ncs- Name:•alot_ie ic,t4 e 4*-
Address:Co,5 FP,C ' .Cirj Company:-J.i-C)
City: 1f. State: ri. Address: I.R 4 to —79 TH T= 1,2;
Zip Code:.3444IS i Fax: City: .C; State:I FL--
Phone No.30t 3/5-SYGO Zip Code:3S4 Ia-- Fax: 5141
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E-Mail: - Phone No. 5L4- CS _ .
FIR in fee simple Title Holder on peXt page(if different E-Mail:
from the Owner listed above) State or County License: e 6-3 O. a 1. -
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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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.Luce County makes no representation that Is granting a permit will authorize the ermit holder to build the subject structure
- which is in conflict with any applicable Home Owners Association rules,bylawsoran covenants that may restrict or prohibit such.
-structure.Please consult with your Home Owners Association and review your deed or 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.Lude County Amendments.
The•following building permit applications are exempt from undergoing a full concurrency review:room additions, .
accessory structures,swimming pools,fences,wails,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
! 4commencing work or recording your Notice of Commencement.
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Signature of Owner/Lessee/Agent + ature of Contractor/License Holder
STATECOUNTY
OFF (Di t.Uc\E CCOATE UNNTYOFOlig/ , 'J CV !
COUNTY OF
The orgoing Instrument was acknowledgenttefore me The forgoing instru ent was acknowledged fore me
thi day ofAJ `a. e,T L-Liy this 1 day of 20 IL by
,.poi***'#%.,, . . • o,N ANN MCCLAIN
. ;��,���F�N}�� �*i`i,� ;� Commission#FF 966622 - .
�'1 1,04,.,,1, My Commission Expires L ) Lura`,v O' On44--
Rl 3, '1,,7- Me►eh Oi, E020
. . .(Name of person a • - - (Name of person acknowledging)
•
INS
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'(Signature of Notary Public-State of Florida) (Signatu of Nota ublic-Ste of Florida) '
',•>-Y - Personally Known OR Produced Identification Personally Known r✓ OR Produced identification
.~ - Type of identification Produced - j=L (UDA Type of Identification Produced
z •_Commission No.-A U.t9\Y 2 2SQRY AU81i AYOUNG,
(Seal) Commission Pio. ao .. . c
_• - - - 4 MY COMMISSION#FF 951059
0,3K,-,1%,..4444,r EXPIRES:•Apri112,2020 •
•-',\' -,:::\- - - a"pp phO Bonded Thr Budget Notary Serrices ti
'. '`Revised 07/15/2014
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REVIEWS FRONT ' ZONING SUPERVISOR PLANS • VEGETATION SEA TURTLE MANGROVE -
COUNTER REVIEW REVIEW REVIEW - REVIEW REVIEW '. REVIEW
DATE '- '
COMPLETE - ---
INITIALS - - •