HomeMy WebLinkAboutSHED LESS THAN 144 SF ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED d
Date: a Permit Number:
RECEIVED
in IM
Building Permit Applicati n
SEP 27 2018
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 5�
P=ROPOSED II_' 'k'0VEMENT LOCATION ff { y
Address: ` ' 1 C P 39-I 1-15
Legal Description: G - 1- (^Cr
Property Tax ID#: - 0 d Z Lot No.
Site Plan Name: G d 1 v3'tcjo Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
CONSTRUCTION INFORMATION 3
1
Additionalwork toe e orme under this permit-check k all= 1 appy:
OHVAC Ei Gas Tank Gas Piping _Shutters ❑Windows/Doors
Electric ElPlumbingSprinklers ❑Generator Roof Roof pitch
TotalSq. Ft of Construction: 14, 0 Sc -f'h„ S Ft.of First Floor:
Cost of Construction:$ 3®�. Utilities:11Sewer E
Septic Building Height:
OWNER/LESSEEf vp CONTRACTOR. ` ,
y ,
3
[Name 1 Ks 6 n Name:
Address: I n,J Company:
City: U I,2 r 02 State: Address:
Zip Code:3 ga`-f S Fax: r City: State:
Phone No. - Zip Code: Fax:
E-Mail: 0%J a d 0 li of ® rirni . <� Phone No.
LJ
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN�LAW INFORMATION :
,s �_ . . �...
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 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 attorney before
commencing work or recording our Notice of Commencement.
Signature ofOwn Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA ` n STATE OF FLORIDA
COUNTY OF— , COUNTY OF
The oing Inst ment wa ackn wled ed before me The forgoing instrument was acknowledged before me
this hay of 20LL by this day of 20_ by
Nam of person making statement Name of person making statement
Personally Known OR Produced Identification 4 Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced -p_ou Produced
(Signature of Notary Public-State (Si nat f Notary Public-State of Florida)
ROSAIDA NIVAR
Commission No. s aJ) Com issitin No. (Seal)
Notary Public—State of FI ri
` Commission#GG 0997)7
My Comm.Expires May 1, 021
REVIEWS FRONTSUPERVISOR PLANS.* VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW` "REVIEW'' REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17