HomeMy WebLinkAboutDRIVEWAY PERMIT ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED U
Date: Permit Number:
RECEIVED
SEP 2 0 209$
Building Permit Applicatio
Planning and Development Services - ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 5r205 PAleo 1,1mss Crit
Legal Description: lig
Property Tax ID#: 1,3/2 !&o/ • c9151- 6122-3 Lot No.
Site Plan Name: Block No.
Project Name: /,,L1ode Alor
Setbacks Front 0 Back: gS Right Side: 4610 Left Side: /f
DETAILED DESCRIPTION OF WORK:
teeh7ovL uitw We GP C1/41-1A
74r2 0.
CONSTRUCTION INFORMATION:
Additional work to be nertormed under t ispermit—check all that appy:
HVAC Gas Tank F]Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing []Sprinklers ElGenerator 11 Roof Roof pitch
Total Sq. Ft of Construction: S . of First Floor:
Cost of Construction:$ �6� Utilities:Sewer F]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name .1f ,? o Ec✓a4 Name: L u11 AI0rui'i
Addressr:_ 20,5 IGD � 5 �� Company: ��1/C� C'a/i-e�P Owc-1 Go 444
City: ! �' pi efc e State:' Address:
Zip Code: 3!j",5 Fax: City: Wo 8t.ac A State:_ '
Phone No. 772- `/5 gY33 9' Zip Code: 32`J6 J Fax:
E-Mail: Phone No. 7�Z 67-3 3'`1
Fill in fee simple Title Holder on next page(if different E-Mail: AAA 40V 6/12141 e'0-;7
from the Owner listed above) State or County License: �,L7G/3 %
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: A Address:
City: State: City: State:
Zip: Phone: Zip: Phon
FEE SIMPLE TITLE HOLDER: of 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.Lucie County makes no representation that is granting a permit will authorize thepermit 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 attorney before
commenciniz work or recording our Notice of Commencement.
ignaa Owner/Xssee/ ntractor as Agent for Owner Signature of o tractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 6-i • COUNTY OF -S+_ L QsA
The forgoing instrument was acknowledg�d�efore me The forgoing instrument was acknowledg before me
this`d. day of 20 by this day of S�p- ,20 by
y v\ w\ata 7v4-,\ �As qVN
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Pu lic-State of Florida) (Signature of Notary blic-State of Florida)
Personally Known OR Prod ced Identification sonally Known OR Pr uced Identification
Type of Identification Produced - `_',�64�F,a$ T e of Identification Produce�� t „
3d� .o P ,,- D OMM SSIflN#GG 0220 NNA MARIE GIVERS
Commission No. d ,co.Q ($ f�+ De�mber16,20. CO mISSlO } SIDN#GG(M`t�!)
p` EXPIR NSNotary Public unde 'sere e ti 'o �(PIRES:December 16.2020
BondedTh �•oNr o ded Thru Notary public undenarite .
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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DATE
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