HomeMy WebLinkAboutBuilding Permit Application Sep 10 2018 9:55AM HP Fax page 2
ALL APPLICAB LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9 Permit Number: �` oc\-O\I a
RECEIVED
1�l
Building Permit Application
Planning and evelopmentServices SEP 1 0 2018
Building and C de Regulation Division
F,, Lucie County, rmittin
2300 Virginia venue,Fart Pierce FL 34982 - - 9
Phone:{772} 62-1553 Fax:(772)452-1578 Commercial Residential
PERMIT AP ILICATION FOR: To Select from dropbox, click arrow at the end of line (X Iz_
Address:
Legal Descripti n: Loa, Ma III n 1316 W or>10�3-)362
Property Tax 11 8: 1,3 6 [�v 9 -0,k a0d -3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Frc nt Back: Right Side: left Side:
aLe Ive, M A � . 19' 6 5 jrs e"m L. e
RVtAV vv ILI Seer ,g }� w e,P,�
i 36 054,01 r :Y'01
--AdcIfflonal wor o eDerformed under this permit-cheCK all that apply:
L-JHVAC Gas Tank []Gas Piping —Shutters a windows/Doors
Electric 0 Plumbing ❑Sprinklers 1:1 Generator Roof Roof pitch
Total Sq.Ft of onstruction: tt �: S .Ft.of First Floor:
Cost of Constru tion:$ Oa Utllities: Sewer L_!Septic Building Height:
MAI'M
NameG aU v- Name: ect2.ru,vC S
Address: Company: 191 f, f~ N r d
City: tti j2'i e r` State:,E(E( Address;
Zip Code: 3 8 Fax: City; e,f G Stater
Phone No. 0 Zip Code: .3 4 5 P 2 Fax: g - G 0 —GG 13
E-Mail: Phone No. - 460- 24 ,;,5-
Fill
60" 24 ,;,JFill in fee simpl a Title Holder on next page(If different E-Mail: r r_o,, ro) a 6 19' ? tea ,cv r,
from the Owne r listed above) State or County License: 6,4C'4
.If value of constr coon is$2500 or more,a RECORDED Notice of Commencement Is required.
Sep 10 2018 9:56AM HP Fax page 3
t
DESIGNER/ NGINEER: ,Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City; State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE ITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City; City:
Zip: Phone: Zip: Phone:
OWNER/COD TRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no tvark or installation has commenced prior to the issuance of a permit.
St.Lucie Countyy akes no representation that is granting a permit.will authorize the permit holder to build the subject structure
which Is In confli 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 w th the approved plans,the Florida Building Codes and 5t Lucie County Amendments.
The following bL ilding permit applications are exempt from undergoing a full concurrency review:room additions,
accessory struct ires,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TC 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, ork or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FL RIDA STATE OF FLORIDA
COUNTY OF ,.Stl' L v G L COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrume t was acknowledged before me
this,Jp day -re-Pyr r-+b e-r _,20A by this��day of e a m +r 20JA by
Name of person making statement Name of person making statement
Personally Kno vvn 4 OR Produced Identification Personally Known_, _OR Produced Identification
Type of ldentlf c tion Type of ldentifi ation
Produ Produced � K .3 +►r�
+;;µY PATRICIA A.GARYON t� `,,+�;', , PATRICIA A,GARYON
lacy Public State of Florida Notary Public•State of Florida
° - ct 13,2018 Ca mi Oc 3 018
(Signa r�' , ry pu on (Sig tfiC a - rr
' Band ThroughNationaQN aryAssn. ++� �ondc roup , 1 �Qary
Commission N. 1 S (Seal Commission No, J.3 3.s'0 o (Seal)
REVIEWS' FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
e