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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED f Date: 10' I e Permit Number: /t �'V T ^'`- i COUNTY j. F j. O R I D A RE CEIVED Building Permit Application Planning and Development Services �Cr `�'0 2018 Building and Code Regulation Division Permitting De 2300 Virginia Avenue,Fort Pierce FL 34982 St'.Luc, 1.1 2300 ty 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: cl Li aZ 0 r\r12o.,--k_ C_�k- Legal Description: n - c —,,I0 c.,,-co-v---/ c- kd CA./ - � ` o+ !()co Property Tax ID#: t 3 2'1 ^ �o `- ©C.3S5 --Cpc:=CD C_, Lot No. (, Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: eIcoL'c pool re_00 e.71-,1-6\---\ v\ 4ec r 9 6. CONSTRUCTION INFORMATION.. Additional work to be performed under this permit-check all;ha apply: HVAC _Gas Tank Gas Piping I Shutters ❑Windows/Doors 0Electric ❑ Plumbing Sprinklers , _Generator _Roof Roof pitch Total Sq. Ft of Construction: ' Sc. Ft. of First Floor: Cost of Construction:$ ,o2 t-('C , ©c) Utilities: I _Sewer DSeptic Building Height: OWNER/LESSEE. ` CONTRACTOR Name :TomA ., -t-resi n. Name: `50. ,v\ (,v%\\;QHS Address: -f G'L pZyve-loc v-[� c4- company )Oto._.` (x...i.u-e— ?Oo\S NNc City: 4+- y -c,= I State: c(,._ Address: ZG,') -}T,c-,i N. oct4P,... --i-k-- Zip Code: Fax: City: --r-t- pl erC-,e._ State: 1L- Phone No. TY2_ 353-%36::•Co Zip Code: 34 Fax: E-Mail: Phone No. Y7 2._-°1( '1- 13 33 Fill in fee simple Title Holder on next page(if different E-Mail:--rj 4o.Q t.%---4-1)r?15 C. comic_ ,ftei-- from the Owner listed above) State or County License: C(7 \-45'7 a q'3 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SIJPPI.E_(VINT,AL,CPNSTRUCT CH9 LIA6N LAW�II arRMATIO _ ma -, -- DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable1 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 confli ct 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 1 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. 6-421, -‘ lv✓ Signatu of Owner/Lessee/Contractor as Agent for Owner Signatyrre of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 0- cams_, COUNTY OF The forgoing instrument was acknowledged before me The forgoing instruum,��e t was acknowledged before me this 3 (D n day of c ,20 l% by this'30 day of VQ , 201? by G— f person making statementame of person making statement Personally Known OR Produced Identification Personally Known OR Produced Identification N Type of Identification Type of Identification Produced -----1--. Produced }-L C-Sc-a\ - \1'4)--3)f°{sf - q-' (Signature of Notary Public-State of Florida) Signature of Notary Public-State of lorida) n. .��-•^5-.n"`` ....min--.:,rt..�. .. ,. ``ara"•. �S HAHNAINGRAM � `,,,a�P`" (S6� IAHNAINGRAM Commission No. .`P—" S commission No. } ._, „o, Wary ublic State of Florida ,��.�; Notary Public-State of Florid a ,•: it. *•e My Comm.Expires Dec 20,2018 , •; ik. *•e My Comm.Expires Dec 20,20 8 rr 4`= Commission ;`FF 177249 4 ' ;r 3;i .N„n.L►6 ,\; Commission ;] 1,. ' yi''ia'` Gal;:d1? A; •v.,,i R,C.-� '4, o. Bonded through�. I b. p F;,o r;n� n. REVIEWS FRONT ' --'ZON1N—G-7T SUPERVISOR PLANS VEGETATION: SEA TURTLE MANGROVE COUNTER, REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17 I