HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 Permit Number:
RECEIVED
W-
Building Permit Application DEC 0 3 2018
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 / u
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential (/
PERMIT APPLICATION FOR: 1014.
`•`v�moo.
Pf' pC}SdDIRFG ENIEINE
Address: `�39 �f eljl � d�7L
Legal Description: DrIaec�
Property Tax ID#: 3 7 1 �0,� "OD 7,`— DDD Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
ED
rtiona wor to a per Orme un er t is permit—c ec at at app y:
_Mechanical _Gas l ank^ _Gas Piping _Shutters ' _1Nindows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: ... , > Sq..Ft. of First Floor: {_ f: _
Cost of Construction:$)$41, Utilities: —Sewer _Septic Building Height:
Name ` cl^' i/1 � Name: :•YZ', Q R,t,
Addrress ' %* /U� �Cfyl Company: }. U t cf'/��' art S 1 "
:. _. �� Address: 1 � � :� t4��'2j. ' rV oe
City: 0/'7`, Si.EI G,� State:
Zip Code: Fax. City: _..T�`e�r „ State:
Phone No. 66— Zip Coder"A�— Fax:
E-Mail: /Ylar`7`%r� /Zc� a ��/n Phone No+, 9�o ` �_
Fill in fee simple Title Holder on next page(if different E-Mail Tg �ra ,%a , I,&4A 7 o q,,(u o
from the-Owner listed above) State or�urity Lice e i
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
D
SUPPLEMEN 1L C�NSTRU'CTION LIN LAIN INFORMATIQN:
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'`obfaln a'pe'rm1t tci 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
commej3r,ing work or recordin ur Notice of Commencement.
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Signa ure of Owner/Lessee/Contractor as Agent for Owner Signatur Contractor License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5�, l.\�c'\� COUNTY OF' S-i'• -�c�u`Z
The forgoing instrur7tent was acknowledge before me The forgoing instrument was acknowledge before me
this�day of U-� 20, by this 3 day of p8 .20-a by
4 t C \-rL `c c v\
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary P lic-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced "�" "='=" Produced -+~
,�+•,• IE GIVENu
s ,N,•,•,,,• FANNA MARIE GIVBNS
,, � "'� '•�� MY�MMISSION#GG 022(123
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Commission No. S:De 2020 Commission No.�s- a� mber16,2020
.'%'.�,di�;;' BottdedTlxu Notary PublieUnderwrtlers o�R�••� BondedThru Notary Public Urldemritefs
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE. MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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