HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: "tT 1—]i * Permit Number: i-or."7
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� s I_ RECEIVED
ee .,- BuildingPermit Application Permitting Depart
Ment L 0, R , „ DEC 172018
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Planningand Development Services St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ,
Phone: (772)462-1553 Fax: (772)462-1578 Commercial _ Residential V
PERMIT APPLICATION FOR:
PROPOSED PROI%EMC LOCA (As.. A, • ,: - . -. Vis. ;,
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Address: J O i, l , ',eel f LI . /.eau i F l/
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Legal Description:
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Property Tax ID#: 11431 ?Da- CO.5¶' COO /(c' Lot No.
Site Plan Name: Block No. 1
Project Name:
Setbacks Front Back: Right Side: Left Side:
AILED DESCRIPTION-WORK°
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/o y i 0 ae, Aced .red (STb ,rage
PnCinoFia.cvr�
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CONSTRUCTION ilm-po At of a ' . ,
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: /00 fl- Sq. Ft. of First Floor: -- 1
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Cost of Construction: $ './OO 'in U41 Utilities: _Sewer _Septic Building Height: �
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OWNER HES E:. _,• . j `:'.W CONS RACTtO,R
Name L. / U'> A../_`i Name:r i
Address: /f 7 , LJ( • ,i — /' ' Company:
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City: -- ,. / ' I State: -FM Address: _
Zip Code: 7'4k* gFax: City: State:
Phone No. R 7 /' 15 A 3 Zip Code: Fax:
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E-Mail: GI to, Irc e, I rSc, ed(11 Phone No
Fill in fee sini0e Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License
1
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
SUPPLRMENTAL:CONS )RUCT MIMI LAW 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 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
comme cing work or recording your Notice of Commencement.
AL(LJW )641,Zie.
Si n ture of Owner/Lessee/Contractor as Agent f wner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF s Lu,c(P, COUNTY OF
The for:oing instrument was acknowledgedefore me The forgoing instrument was acknowledged before me
thi fig oay of j•' .. 20 �. by this day of , 20_ by
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• ane of person making statement. Name of person making statement.
Personally Known OR Produced IdentificanV Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced FL— D L Produced
(Signature of Notary Pu. ignature of Notary Public-State of Florida )
��`"YP',/4 ELLEN VAUGHN
SPR U8
Commission No. '_° „_� � St 3@�y�Florida-Notary Pub KC mmission No. (Seal)
0-3 *c Commission #GG 270079
ZtpF��oQ,� My Commission Expires
O tobcr 22, 2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 8/2/17