HomeMy WebLinkAboutBuilding Permit Application ii All APPLICABLE INFO
MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: if • �;� • ) Permit Number-
.: LRECEIVED
Building Permit ApplicaOCT 2 5 2018 .
Planning and Development Services ting Department
Building and Code Regulation Division ciCo2300 Virginia Avenue,Fort Pierce FL 34982 tyr FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Re
PERMIT APPLICATION FOR:
PRC?PO. ED 1,N RC11/EMFE1NT' L�C 1'I �'N:
Address: -3ZlD
Legal Description: I'll-9 lA I/iG[fl 6744.r> S,Ap /✓/T
Property Tax ID#: 2 7 2- / 0/ 06s7 0/0 Lot No. /46D
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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itiona wor to ape orme under this permit-checK all that appy:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: / •S T Sq. Ft. of First Floor:
Cost of Construction:$ d Utilities: —Sewer _Septic Building Height:
Name J4>1 eLL e- Name: 1'/)CTl1 J. �7/.,iGv
Address:7076 A/n/ 4✓, '9 Company: 6-WrIL c5' /Y01VC! Lc.- C-,
City: OC--,46W State:j�- Address: /_02- -SIP `" c xA-_-.•/Jg G,_/9 eiF
Zip Code: 3�/'9-Sj Fax: City: PS 4- State:_J___e__
Phone No. 0 7 IWO Zip Code: 3 YII�S".3 Fax:
E-Mail: Phone No 7�Z- 12
Fill in fee simple Title Holder on next page(if different E-Mail _1 i/-L"J C-0 Com'z",,'-fl-,5/1or�1�S, Gate!
from the Owner listed above) State or County License G%Z--e- Z9
Evalue of construction is 2500 or more,a RECORDED Notice of Commencement is required.
i
SURPLEMENT,At, CiJNSTRU�TI�N L SEN W 1 - 'FURMA IU'N:
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 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
commencing work or recording our Notice of ment.
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l....Nor:
Signature of Ownerkiee/contractor as Agent for Ow gnature of C tracto cense Holder . �
o x0
STATE OF FLORIDA z m ATE OF FLORID rn<
COUNTY OF �'Cn UNTY OF
00
M�M
TheJprgoing instrum t s acknowledg efore me �T e f r ping instru}}��e t was acknowledg efore m z �
thi m
day of 20by a g� t is day of O` 20by
Name of person making statement. Name of person making statement. N
Personally Known OR Produced Identification Personally Known / OR Produced Identification H
Type of Identification Type of Identification
Produced Produced
A A
(Signature of Notary blic-State of Florida) ( ignature of_NT Public-State of Florida)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 812117