HomeMy WebLinkAboutBuilding Permit Application s. PP EM j CONS =RUCTI® lam q :0°MATI0 , _ •i° . ..
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: 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 represu
sentation that is granting a permit will authorize the permit holder to build thesubject 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
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.
>
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF • A COUNTY OF
The forgoing instrum,nt w s acknowledged Q u
.sem tc R The forgoing instrument was acknowledged before me
this f' day of - , 20/e5-414;.;;;;5' ` this day of ,20 by
' m r
/ /1"))0, �( !/6- i ; a g g .
(Name of person acknowledging). g v Q (Name of person acknowledging)
.5 wcn= •
�c t
. c ate
4d§/ ,, ►t. lieuaN,T, .
(Signature o r otary Public-State ofFlorida) 1 cN ' (Signature of Notary Public-State of Florida ).
5
Personally Know A OR Produced Iden -.'••s-.-
Idents -.---.- -" Personally Known OR Produced Identification
Type of Identificatio ��))� Type of Identification
Produced �: , . DI .�L G Produced
Commission No. • (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 7/2014
r
All APPLICCA,B E
`► .INF• MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED •
,`j
Date: - F a\'z Permit Number: /31)9'.- --
.. ar u"�87yda' }`4 _ 6:113:_1-,;ATtik.--;47.vjl
fi_Ja �' .sr'`� �m �`CO
F L C7 R 1 C► A�. - Building Permit Appli atn SEP 4 2018
Plannin and Develo ment Services :• , t
1 Building and Code Regulation DivisionPel�Cii�� �' rr�leil2300 Virginia Avenue,Fort Pierce FL 34982 . Lucie ci7t,�ity, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial esenial
PERMIT APPLICATION FOR: __/ ����
PRU'POSED- Y /_)&61-9f- .
°RDVEMENT LOCA,IQNo ,.. • s .. .,:.,......4. •
Address: --9- 1--)1 SPIN �.:�-rea_cp5 f P_
Legal.Description:WA-----re---e_. H TC .
Property Tax ID#: 001-LOCI - o(a@-000- 3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
xQl aD DESS oRIPTI O b , a. o. ! . $ :.l% .g.•b :,:5,.;`
w H T€.-- . (. y a LLc . 1� C ,1 k .
CONSTRUCTI@ "I,NF®RMATIONo `'g - - .
Additional work to be performed under this permit-check all that apply:
Mechanical _Gas Tank Gas Piping - Shutters Windows/Doors ,
Electric. '✓Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: 1
Cost of Construction:$ .oO• o 0 Utilities: Sewer: Septic Building Height:
.AWN ER/LE-ES`SE ° A . CONTRA OR? u , 4 '::: ,.' °'''''',',;*2's
Name-0..A1-1,r (VI IL U A— Name: .
Add ress'a-5OI SO-4\S C-47i'2-t-JOS C)fe . Company:
City:f012T Pc '—C-E State: 'ft___ Address:
Zip Code 34 "7 Fax: City: State:
Phone No.17Z_ Zed 4-9(1 . Zip Code: Fax:
E-Mail: e, 1'Y1• rYI1h(wa"oCc�I •C.crvi• Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
1 from the Owner listed above) State or County License
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.