HomeMy WebLinkAboutBuilding Permit Application J
•
ALLIAPPLICABLE INFO MUST BE-COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Perm it.
R 11" 41P
E%,Or.JL-v
f NOV 15 2018
t Building Permit Application
PIG ningand Development-Services - Permitting department
But ding_and Code Regulation,Dlillsion
St. Lucie County, FL
23C 0 rgi»ia Avenue,.Fart Pferce:FC 31982
Phgne .(7.72)462-1S53 Fax.(772)462-1578 Commercial Residential
I I
PERNIIT;APPLICATIO;N FOR: To Select from dropbox,click,-arrow at the end,of line
PAFOS£ IIVtPROUEM'ENT LOCATiON'. .f
Addr ss:
i Legal Description:
i
Prdp6rtyTax ID#:J {I -703--0052 - OW-`j Lot No:
:Site Plan Name: ! Block No.
Project Name: .. I
5etblicks Front 3 Back: Right Side: Left Side:
l
(I"EDQDESCRI ETI,ON QF 1NQRKL k _
_ _ _ .. ..
6c,
jeeAcialr-"
'Ct�iUS;fi�R11'CTIOI;�iII�FQRtIi?IATI�N _� �" � _ r '�,`
l onal worktoe
' un er is t--check,a" app,y:
HVAC Tank Gas Piping Shutters Q Windows/Doors
+Electric Plumbing [3Sprinklers Generator _ Roof roof pitch
Totalq.:Ft of Construction: SCI.Ft.of First.Floor:
IDCost oConstruction:$ is .� Utilities: Sewer E]SeptIc Building Height:
i
iOW ER/i:`E5SEE; _
IP
"S
Name C !fit'5 Name:
Addrei ` 5 :" i tr u... �,• Company: LJ6 I
y
city: State: Address: e .
Zip C' de:_349W 1 Fax: City: '-�- State:
PhonJ No. Zip Code: 3 7 Fax: &q-11,2 '�7
E-Mail: i Phone No. -
FIllin i ee simple Title Holder,on next page(if different E-Mail:
V from the Owner`listed above) State or County License: 0,4C I V _3F
i
ifvalue of construction ls'$2560 or more,a RECORDED Notice of Commencement is required.
#` I
=Slat P IEMENTAL CONSTRUCTION LIEN=LA11N INFORMATION'
.•
,
DESIGNER/ENGINEER: _Not,Applicable MORTGAGE COMPANY: _Not.Applicable
Ne,r e• Name:
Address: ! Address:
City: I State: City: State:
Zip Phone Zip: Phone:
FEE,SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Narrte� Name:
Adc'ress: Address:
City: City:
'r
zip: Phone: Zip: Phone:
a.,
OWER/CONTRACTOR:AFFIDVIT:Application is hereby made to obtain a permit to do the work-and installation as indicated.
I-cert fy that no work-drinstallation has..commenced prior to the issuance of a permit:
St Lu fie.Coun makes no•representation that is granting_a permit vve�rr ll authorize the.permit:holder to build the subject structure
which'is in con�ict,with anyapplicable Home Owers Association rules,bylaws or and covenants that:may restrict ot-prohibit such
struct, re.Please<consult with.y"our Home OwnersAssociation.andYeview your deed for.anyrestrictions which m" 'apply.
in consideration-of the.granting of this requested permit,1 do hereby agree that I will,in all respects,perform the work
In accordance with the approved plans,the Florida Building'Code"s,:and St.Lucie CountyAmendments.
The fo1lowing building permit applications are exempt from undergoing a full concurrency,.rev..iew:room additions,
i accesslorystructures;_swimming pools,fences,.walls,:signs,•screen rooms and accessory uses to another non-residential use
WARNING TO-OWNER Your fall lure.to Record*Notice of Commencement may result in.,your paying twice for
improvements�to.you property.A Notice of Commencement must be'recorded and' steel-on the jobsite
E
before the first_mspection. If you intend;to pbtain,financing,,consuit with lender or an attorney before
`
commencing work or irecordi'n our Notice of.Comrrteritement.
ure of Owned essee/Contractor as Agent for owner
5i ture.:of Contractor/License-Holder
l {
E STATE OF FLORIDA ' r STATE 00 FLORIDA
'
COL NTV OF -e- CO.LINTY OF � c-•c ''
{
E Theprgoing.iinstrurhentlw s:acknowledged before me The forgoinginstrurhent wal acknowledged before me
this,- day of Azye k-, I-/ (( 20(_`r'by this f_�L day of //otic,�-r .2012 by
{ Na "e of persp6_pmakingitatement Name of person making statement
{ Personally Known OR Produced identification Personally Known; /OR Produced:ldentification
Type of Identification 1 Type of Identification
( Prod iced { Produced
i
t (Signature,of Notary-Pu ic��, aq�f Florida) MIKE'MARTiN Signature of Notary Public altp,jo� Jda) MIKE MARTIN
S .`�; Notary Public. State:ot:Florid Notary Public State of-For ,
Corn I fission No. : ($W)s9Ion�F FF.218951 ommission No. .'-M • =(Seg4)"mission#FF 218 b
'IP, My Comm.Explres Apr5,4201 fill,
My Comm.Expires Apr 5,2 9.
.,? Fra
'���°fiu�• 8oridedtlenuph NatlonalNotary' Bonded,through National Notar : n.
t ,
RENi FRONT ZONING SUPERVISOR PLANS VEGETATION SEA-TURTLE MANGROVE
I I COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW 'REVIEW
DATE I
} REdEIVED_ I
DATFr ?
COMPLETED
Rev,8/ /17 i
f
ji
. I