HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED.FOR APPLICATION TO BE ACCEPTED (�
Date: kii) et) Permit Number: (-A (' O
Vic,_ i Jir . ( '.
RECEIVED
COUNTY - APR 12 2018 -
.F' 4._ o 'R t D l; =-
Building Permit Application permitting Dur ph Planning and Development Services St.Wcs Cour,ey.
Building and Code.Regulation Division.
2300 Virginia Avenue,Fort Pierce FL 34982 .
Phone:(772)462-.1553- Fax: (772)462-1578 Commercial - Residential _ "
PERMIT TYPE: '
PROPOSED'IMPROVEMENT LOCATION` ; `
Address: 1 3 S '. 06 vh/Co'6'h (. ' .
Property Tax ID#: I 914-1-170 /— 01 i 7 C9oo.-, Lot No. L
Site Plan Name: Block No. 1 3
Project Name: ,
DETAILED DESCRIPTION OF WORK: -•
1 L a-/L ki L/1' 2110 v ,2 d 4'(At e-i(i'`LA1`l: -4b/ NU'1 r'l.l' S•' 1, 1" `OA
.J-Or t, AAc�11 p ��(04 •- 0-- 6 r 92,'u,`c-e. -c�-�-
CONSTRUCTION INFORMATION:
Additional worl<`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: Sq. Ft.of First Floor:
Cost of Construction:$ 100 Utilities: _Sewer Septic Building Height:
.OWNER-/-LESSEE: „•' . . CONTRACTOR: .
Name 14!1'5 /44trName: -j'I fN Ph L-
Address:` '3 S I" 1,Jt?y mi nilly. C. Company: ..
City: jot-,Piit L' State: Address: ; 'S:. (.)
? OV F6'nt4°l'PdGl Jv"C- _
Zip Code: 3 try V I Fax: City: P1-,1'pL°tt State: 1-L
Phone No. 3D 1 t-J 3a ' q LS Zip Code: ti.14 7 Fax: t-')lafe - OSf°
E-Mail:. Phone No .LIG 6-US OO
Fill in fee simple Title Holder on next page(if different E-Mail IN,i "e,i (CI Le 4 0 I, GW`
from the Owner listed above) State or County License ed--C, I'3 COSs—I
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION"LIEN LAW INFORMATION:
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 represtructure
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 andaccessory 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 JOB SITE BEFORE THE FIRST INSPECTION.. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder,•
STATE OF FLORIDAC STATE OF FLORIDA
COUNTY OF J)- •Lal c'C ' COUNTY OF $t L c ,
s
The forgoing instrument was acknowledged btore me ' The forgoing instru ent w s acknowledged qbe -rim
this Ise day of ,1. ,20 I C1 ':. this at day of t': ( 20'�1 b
_ f oN
Name of person making statement. , g N Name of person making statement. a o„0
U
- / �zz V N. •
a� y
Personally Known ` . OR Produced Ident'a'ioEtipp Personally Known OR Produced ldent' alfa°
Type of Identification 2 8k Type Identification
' Produced
Produced or aX. zU�w
z y�w
c
Y 0/ a
of Not. Public-State of Florida °��
(Signature ) �� (Signature of Notary Pub" lic—State of Florida)
Commission No. 16C6' 6 (Seal) Commission No. ( Sfc-Ve 5"-- ' (Seal)
REVIEWS . FRONT ZONING SUPERVISOR PLANS VEGETATION. .SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW. REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
rev.2/7/19