HomeMy WebLinkAboutBuilding Permit Application AL1.APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date.. Permit Number:
Building Permit Application RECEIVED
Planning and Development Servkes JAN 3 12019
8dildino and Cade Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 ST. LuciQ Co nty, Permitting
Phone-..(772)462-1553 Fax:(772)462-1578 Commercial Residbnt ;941-
PERMIT APPLICATION FOR: To Select from dropbox,click arrow at the and of fine
Address: 4913
Legal Description:
Property Tax ID Lot No.
Plan Name: I SW Block No.
Project Name:
Setbacks Front_ Back. Right Side, Left Side:
9W hi z/
ACrdrit4onaf work to be gerformed under this permit-c ec 5111 ttiff app Y.
9HVAC oGas Tarek []Gas Piping UShutters OWindows/Doors
[]Electric Plumbing ElSpriniders ID Generator Roof Roof pitch
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ Utilities:0Sewer liSeptitc: Building Height;
Name U.-,4 6, 4) Ism Name: UMSUII(Otl
1140 -
ddress: ki-a )GB Company: (*%Warnn Wi-rmAA m�m
State-,F:le- Address:
Zip Code: Fax:�._ CW.
StaterT
Phone No.
Zip Code: ' F a Z L-7-1
E-Mail: Phone No.
"N
A
ss.
(city
5S .M-
'�Modei' :6 -
Code:No. 7n-3 06-4
Fill In fee simple Title Holder on next page(if different E-Mail i 6"M 13aa to 8M
from the Owner listed above) State or aunty License:
if value of construction Is$2500 or more,a RECORDED Notice of Commencement Is required.
DESIGNER/ENGINEER:
DESIGNER/ENGINE Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name-.
Address:
City- stai;: City-
ZIP! Phone Zip: Phone:
D 4�ER/l
ESIr
Name
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-LucieCoun makino representation that Is granting a permit will authorize the permit holder to build the subject structure
which!sin conflict with any applicable Home Owners Agodation 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 prop".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
mmenctrig/work or"cording Your Notice of Commencement. 4,
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Sign q oeil Lessee/contractor as Agent for Owner 5i Wftontiactor/License Holder
ST F FLORIDAFLORID`VATE OF
T
C NTY OF t COUNTY OF
.The forgoing instrument was acknowledged before me The fpi-going Inst Ment was acknowledged before me
thls'�JL day of'kiti" I
20A by thisQL day of 26 0 by
J
Name of personmaking statement Name of perso9ftaking statement
Personally Known OR Produced Identification Personally Known— V OR Produced Identification
Type of Identification Type of Identification
Produced Produced
CRAIG A.ORO 3MAN CRAIG A.SRO SAMAN
.2
MYCO
MMISSION I
el. LE ;A M myoommlwlow
IP,rO2OO
(Signature of Notary Public State, gnatu of Notary Public-State F
�m A F LAM;6rtkiswr
Commission No. (Seel) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISORPLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW [REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17