HomeMy WebLinkAboutBuilding Permit Applicaiton i
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
r ID- col, 0 3r 'VDate
RECEIVED
CCAL1 3or MAY
I �r BuildingPermit A licationersttt'nu,Dc
artm9nr
Dusty
Planning and Development Services ,
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential _ —
PERMIT TYPE:
PRo'°"OSED INNP•-C4/VIENT Lt®'WATION ` a -
e y,.
Address: �t r •• _ %Ns.* ' " .;v L - _ c
�1'i Lot No.
Property Tax ID#: IBJ 0 )r CaC��s--0(-)--,32.--0(x)/,‘„,
Site Plan Name: pern �ock No.
Project Name:
MAILED DEND,IPTION'o ' ,WORK° .e 4
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01-‘41 Li-k- L -N 6 nce -Z l Jo k - P-rte_
€0N- TRUCT Ct".k}„ NFOMA .Ro iA §.
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 Constructi n: /G/ •
elf Sq. Ft. of First Floor:
Cost of Construction:$r3 6 CX9 Utilities: _Sewer Septic Building Height:
CV.. t ./MSSEII := ;i:.5' . CONTRACT '° :. ' , {
Name UY \ L eye- wi���",1;; Name:i3eY\ Ofl
Address: �(1or `uy1. ,Ark. Company: G
,AANO RCI'n
City:1:1- p� ( Stater : Address: 4 � k� �c.�
Zip Code: 31-1CtS1 ' Fax City:T:1- keit State:FL
Phone No. '. ::Zip-Code:3 , -:_Fax:
L ..
E-1Vla l:, ----- - _ ._- .. Phone No 77,2-5(9 " z
Fill in fee simple Title Holder on next page(if different E-Mail WOCC 19 .. a c 01.6 r'( .• (6 kvl
from the Owner listed above) State or County License 5b
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.
1
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SUPPL M NTA =C@NSTR CTION E[L , I IN`F@RMATION6:
,y .,„ .,.. ' ,. , :.:`�` a, �:ea:' ren. - • L .°*.&.
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 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
commencin: A ork or recording ..ur Notice of Commencement.
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Signature o Owner/Le :-e/Co1S{actor as Ag-nt for Owner igna a of Contractor ice se Holder
STATE OF FLO !l,A STATE OF FLORIDA . p
COUNTY O, &OL O I1 V'er COUNTY OF 1 1,1 ooh 12i U€1
The fagoing instrum nt was a nowledg efore me The forgoing instru ent was cknowledge efore me
this - day of � pnr ,20_IL by this-1 day of pn 1 , 20 IL by
Oon EnSYYl1 rger 6eh 1-10,,m Sorg
Name of person making statement. Name of person making statement.
Personally Known x OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
8a T . m
(Signature of Notary' Publi — Signature of Nota Public-Stat o F r'
�,.�No6„•n, AH J. MARINE g ry ��f. 1�
fry--,9„--- e of Florida-Notary Public 'SARAH J. MARINE t
Commission No O( ••0-Q1)•
-• %.�I sion # GG 273338 ommission No. _,•1l&/' �MaatteXtlalI orida-Notary Pubic `
'°%`"70* y Commission Expires *P -' • Commission # GG 273338
November 01, 2022 -',, - ,,.- My Commission Expires
' Nove20
REVIEWS FRONT ZONING' SUPERVISOR PLANS VEGETATION ' �� i ' T E mber 01, 22 MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED -
DATE '
COMPLETED
ev. 9/26/18