HomeMy WebLinkAboutBuilding Permit Application ........:.\*0
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ��9 .01116
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Date: 110'29J-1 0 Permit Number: 1 O�j�V—.0 I 1 6 ,
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COUNTY RECEIVED
F L O R 1 Cs A'
Building Permit Application ,OCT 2 2 2018
Planning and Development Services Permitting De
Building and Code Regulation Division St. Lucie Coy�tv
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential v
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PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of lineill
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PROPOSED ROv4.--.EN ,.00A JdN .• ;g ,i v . N Rim i 4 p l:�s. „-;,
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Address:114 S.c.- C r.,-;Inn St ce e '
Legal Description: Ri. i e r Pat—k. Ln t ) lke-. 3 Q
Property Tax ID#: 3 Z{19 -'5l 5 -O 35 7 -000-a Lot No. ,7
Site Plan Name: Block No. L)
Project Name: Le.® S+U r,-,b 04. )r'�k
Setbacks Front Back: Right Side: Left Side:
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Additional work to be erformed under this permit-check all apply:
HVAC Gas Tank nGas Piping _Shutters 2-Windows/Dia
LJ Electric 0 Plumbing ,Sprinklers U Generator I_Roof
Total Sq. Ft of Construction: S9,21,of First Floor:
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Cost of Construction:$ L{?A, 3 9 Utilities Sewer 0 Septic Building Height:
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Name LLO S±1.)N kar)esk--s•r--VA-Ant Name: .,)c.-eu'atr���►�c-��;•o - q,. -.A._ • ( I
Address QSE C a jninr, Sfr&" Company: k-L @Q.r 9-e c' � k) Q
City:20 c Satr,t L,uc� .e., State: Ft Address: i lQ —let-F-11 Or A
Zip Code:3 t ei S a ! Fax: City: i-C; R.',i k Yti c C<'t 0 i,. State: FF L-
Phone No.-)7 a -50i -5 736 11
_ Zip Code:3�I I a--- Fax: 5 ,1 -. 35 5 ^ef0 5
E-Mail: Phone No. 5-1,j1- S=S-5--- 41LS5 a_ I
Fill in fee simple Title Holder on next page(if different E-Mail: I
from the Owner listed above) State or County License: L. (.9 00 � c7-'t -31
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: —Not Applicable MORTGAGE COMPANY: —Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
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FEE SIMPLE TITLE HOLDER: Not 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 the permit holder to build the subject structure
which is in conrlict 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 r-cording your Notice of Commencement.
_Sig - ure of�� f/Lessee/Agent � 4� F re of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORI A
COUNTY OF �.5k-,�,L_)c\.� COUNTY OF 1f-I vv 80..r.c K)
The for ing instrument was acknowledged before me The forgoing instrumen was acknowledge before me
this( ay oft C0 r , 20 IR—by this /? day of OC i- . ,20 I y by
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(Name of pern-cknowie ging) ZARY Kelly Molloy (Name of person acknowledging)
Q On NOTARY PUBLIC
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'STATE OF FLORIDA fr
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(Signet ---1,f otary Pu%.1 -_ : - • e7'1a txpires 9/1812022 (Signa •re of Not- Publi/ tate of Florida)
Person: •wn / OR Produced Identification Personally Known r� OR Produced Identification
Type of I.en ificati• Prod ced Type of Identification Produced
Commission • (Seal) Commission No. PRVP'j, {OELAYOUN
* G(Seal)
1�,� * MY COMMISSION#FF 951069
". z. EXPIRES:April 12.2920
94'OF Ft.O' Bondad Nueudgol Notary SaMcaa
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS