HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1
Date: Permit Number: II
RECEIVED
K-411111507
Building Permit Application JAN 0 7 2019
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 X
PERMIT APPLICATION FOR: -
R�� OSED 1NPROUE �EN LO ATION:
Address:3 62 N OTL E'M De .
Legal Description: 0 6 W FEN G -6
Property Tax ID#: �? 4 0 3 –RQ 0 A �R "0 a0 IC Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
ET L�D DESCRIPTION
La► cE'M 51V i o = PA M E -EN JHE `"6NcI(i IS 6`Et
A .. P 6 0- e>\Q o p 2 2 � fe ✓v nr � �s�s ►J t?.� �i s..��� AG qo s s
0�7 w c-c�t (A s kbg gj�rVrO 3�iG fe ELi�/C
C� STR�UCTIO � F0` 11JI TIt7
Adaitional work to be pertormed 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: Sq. Ft.of First Floor:
Cost of Construction:$ /1000 Utilities: —Sewer _Septic Building Height:
0 NOR/L&89 1 NT LACTOR:
Name :KL)[-/AA/ L4 r rn lT Name:
Address: O7' •E z Company:
City: f o to T- AZ CG' State: Address:
Zip Code:34 98 e)--, Fax: City: State:
Phone No..70 6– 6 tS3 01406 Zip Code: Fax:
E-Mail: X L) 1 E oSG iV Phone No
Fill in fe simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
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 operty. A Notice of Commencement must be recorded and posted.on the jobsite
before the first in a io u intend to obtain financing, consult with lender or an attorney before
commenci wo ore I our Notice of Commencement.
All
Signa t fe of 0 ner/ essee/Contractor as Agent mC7twiler Signature of Contractor/License Holder
STATE OF FLORIDA �o STATE OF FLORIDA
COUNTY OF 2 m� COUNTY OF
iv �m
The forgoing instrument was acknowledged befo Z i= The forgoing instrument was acknowledged before me
this '� day of 20 by 9�-n this day of .20_ by
�,1-/ �✓ ANT wN
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Id ti ion /n�� Type of Identification
Produced �.�Gt Produced
(Signature of N ary Public-State of Florida (Signature of Notary 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.8/2/17