HomeMy WebLinkAboutDOC091418-09142018093853ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
• Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 3-11 Co YroRlv\rcn 57ovL COUILL
Legal Description7l hE CSrRv~ A-1 SAVANNA CW6
3"10iL-S3o '-1050- JS(nl
Property Tax ID #: Lot No. at -I
Site Plan Name: Block No. 15
Project Name:
Setbacks Front Back: Right Side: Left Side:
I DETAILED DESCRIPTION OF WORK: I
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Name kiL,p L- 0L10r-
CONSTRUCTION INFORMATION:
/JLrApida
Address:3-71 n fnORAli»a� POO& C; -r
workto
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e performed
under
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appy:
City: AJ0 Sfi / U t L
Zip Code: �C/952�
Phone No. '7-7,L 23S :�io6/
State: FL
Fax: 773- 33j - rRo�
jitiona
L'JHVAC
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Gas Tank
❑Gas Piping
_Shutters
❑ Windows/Doors
11 Electric
1:1Plumbing
Sprinklers
Generator
Roof
=
Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 399y
o�
SFt. of First Floor: _
Utilities:Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name kiL,p L- 0L10r-
Name: SEE
/JLrApida
Address:3-71 n fnORAli»a� POO& C; -r
Company: CcfAj� /li 12
c NI No Lo91E S
City: f oaf S4 Lo c 1r- State: FL
Zip Code:34452_ Fax:
Phone No. `'f W I - 321,1�) — �'�R:a
Address:/S; 72
City: AJ0 Sfi / U t L
Zip Code: �C/952�
Phone No. '7-7,L 23S :�io6/
State: FL
Fax: 773- 33j - rRo�
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: CCexi � q I ti Te e k r N fo C GMA, L. Cd r/1
State or County License: CA eo S$ 6 6o
It value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
UPPLEIViENTALCONS3Rl9CTI0N LIEN L4W INFORMATION:
r
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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 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, 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 attornev before
r Nonce OI
�c��
Si of Owner/ Lessee/Contractor as Agent for Owner Si re of Contractor/License Holder
STATE OF FLORIDA I STATE OF FLORIDA
COUNTY OF ST L. cic %aoA—Al I COUNTYOF S -h Locle_ aofj4l
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 1.3 day ofSep3;iml e . 2018 by this y1 dayof�rr/emLC//_,20 lg by
Name of person aking statement
Personally Known VOR Produced Identification
Type of Identification
Produced
(Signature of NotA
tate
Commission No. =.L1•'SCnn
My Commission
REVIEWS I FRONTZONING
COUNTER REVIEW
RECEIVED
COMPLETED
Rev. 8/2/17
Name of person making statement
Personally Known � OR Produced Identification
Type of Identification
(Signature of
Commission No.
SUPERVISOR I PLANS VEGETATION
REVIEW REVIEW REVIEW
State
My Commission Expires
April 11. 2022
SEATURTLE MANGROVE
REVIEW REVIEW