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Home My WebLink AboutBuilding Permit Application r ,-,., - 1 ii ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 5b-/l) / Permit Number: II COUNTY ' RECEIVED [' ;t O 'R I D' 'A - ' Building Permit Application MAY %V019 Planning and Development Services Building and Code Regulation Division Permitting Department St. Lucie County 2300 Virginia Avenue,Fort Pierce FL 34982 / Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential ,1,// PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: 57q —--7-RapicpL _S 6 12.. 1 - /02- Legal Description: --Te(P/Cq(_ S(._k_5 ( (9-7U-,-2/63) o -- 1.-u (U2 2 1-/oOC) ,) Property Tax ID#: c311/O- 5-38-00243- (x6-07-- Lot No. Site Plan Name: Block No. n Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: :; }. Char? dta baci Oder 61oc,k.. CONSTRUCTION INFORMATION Y Additional work to be pertormed under this permit-check all ha)apply: HVAC IJ Gas Tank f Gas Piping I _Shutters Q Windows/Doors ElElectric Plumbing Sprinklers El Generator Roof Roof pitch Total Sq. Ft of Construction: S . of First Floor: Cost of Construction:$ 50Q. 6 Utilities:Sewer IIISeptic Building Height: 1 OWNER/LESSEE CONTRACTOR: Name LJCd►Yle.5 i rt? 1, TTloVer Name: It _ ii a.. / Address:379//--rropiCa/ J S/'S 12 1-ice Company:i Ccl"[.t_/ Llec ect CI City: For+ PitYCf3 State: R. Address: 1010- W /`liU Zip Code: 349Fa._ Falx: City: A/ Pie .Z, State:F/, Phone No. I Zip Code: o3 '1 2- Fax:X77 ?- h6/ 4f4b'i' 7`702 E-Mail: I Phone No. ' - y(o I^ F.3,9 b Fill in fee simple Title Holder on next page(if different E-Mail: icinie3(ya '_QCJ1. C6 h7 from the Owner listed above) State or County License: LC (3(')O 1(0 513 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. I', i , SUPPLEMENTAL CONSTRUCTION LIEN LAVV INFORMATION: DESIGNER/ENGINEER: i _Not Applicable MORTGAGE COMPANY: Not Applicable Name: I Name: Address: I Address: !! • City: I 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 commencing work or recording your Notice of Commencement. g �� seT5 g am.._ ��a. Si nature_o��f Owner!Lessee ontractor as Agent for Owner Sign uY o'Contractor/License Holder STATE OF FLORIDA STAT FLORIDA COUNTY OF ��'tl l.111. .E COUNTY OF �`�� The fo going instrument was acknowledgeq efore me The forging instrument acknowledged efore me this _. lay of ,20 by this ,day of 20 LLby 5-arn.12A RS\06-GUCCA._ o m 4 Ccs 1'--.0_., Name of person making statement Name of person making statement Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identificationf� Type of ldentificatio Produced fC ` �i9 (--. Produced y -L-- D C_...- 1 1 (Signature of Notary Public-Steq,,,pn*a ELLEN VAUGHV ig .tureofN. _. • -!, ,.- :, ,. ,,,. -_ ,.-.. : r-State of Florida-Notary Public ,,ti++++,,, ELLEN VAUGHN Commission No. ' '* "�" *t5�knmission #GG 270 fission No. �` YPG8' State of Florida@ y Public *%,7)$.101,11,/,$'` Commission Expires �n l �,, My *= Commission #GG- 70079 October 22 2022 - % ' ,r e.' ;,/, i� oec My Commission Expires lra . October 22, 2022 _ .REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17 I 11 1 i