HomeMy WebLinkAboutbuilding Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I I
Date: ;j l Permit Number: I l 1 f I
RECEIVED
Building Permit Applicatio NOV 2 8 201
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 -moi
PERMIT APPLICATION FOR:
PROPOSEMENT LOCATION:
Address: I.d fo er+y � �e • 1�ics�� L L)C,& ,
Legal Description:
Property Tax ID#: �' Q Lot No.
Site Plan Name: Block No. -
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DEOW TION OF WORD
fk-
00
f40 eS
C fry
C+ .STR�UCTlO: INI=OR r TION:
Additional wor to a pertormed under this permit-check all tat appy:
_Mechanical —Gas Tank —Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construct'•n: Sq. Ft.of First Floor:
Cost of Construction:$ Utilities: —Sewer _Septic Building Height:
Name ieC s:. .,Name: f, �,'II�I� .. e `-�`r!'iS�J)�
Address: x Company:.- n oVIU
:.City..� 1-e`GY. _ State: - Address:
� -
Zip Code: ''�tI ( Fax: City: Wit. ;C^c State:ZL
Phone No._ZAZ-!!� 1 Zip Code: 3`lf(rn,l Fax:
E-Mail: Phone No 77 -619-2-Co 2
Fill in fee simple Title Holder on next page(if different E-Mail -e c G"
from the Owner listed above) State or County License
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
E� ALt31�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 of Own r/Less a/Contractor as Agent for Owner Igna of Contractor/Lice se Holder
STATE OF FLORIDA - STATE OF FLORIDA
COUNTY OF A& COUNTY OF S-1-- Cwl c�,2,
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this Q4day of )(WAYVr_-�.� ,20i_e by this,�-*I`%'day of KrTFPnA\Cel-e' 20 IT by
�I I C,P, �l Q,t,c,�h.��� �n la� I Y�• C� (-�rr Zsav�
Name of person making statement. Name f person making st tement.
Personally Known_ OR Produced Identification Personally Known OR Produced Identification_X
Type of Identification Type of Identification
Produced Produced EL L—
(Signat e\of Notary Public-State ( ignature of Notary Public St
_ TAYLOR AA�°►RIE SCHLI " ',;•• TAWANDA PINKSTON•CASTRO
Commission No. � Z '.� 8 L4MISS10N#FF193 C /-'G 6) G (SIN t Public-StateofFlorida
27.2019C mmission No. l�� /, .� � _ t mission GG 099917
EXPIRES January My Comm.Expires May 1,2021
IdideNOterys'vice.cm
Bonded lhreuch Ralicral Aelary Assr,
U
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED _ -
ev. 812-117