HomeMy WebLinkAboutBuilding Permit Application 1�
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Date: ty fi ® �• Permit NumE-E
Building Permit Applicatio � p 2019
Planning and Development Services �eBuilding and Code Regulation Division partment i
2300 Virginia Avenue,Fort Pierce FL 34982 Countv, FL
Phone: (772)462-1553 Fax:(772)462-1578 Commercial _ -
PERMIT APPLICATION FOR: Shed, r *- _ cn J r
0
PROPOSED IMPROVEMENT LOCATION:.
Address:` 9 6'Yr—a xsw- Delve ,
Legal Description::rnd[dR 1:pro 2-s11Gs– 4 W 6 ,[et
.Property Tax ID#: _3-^l6,2* Lot No. I_
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: 3,2 '' Left Side:
DETAILED DESCRIPTION OF WORK:
re- tF r ' I?-&—,e l^e- `tro cle��'rr�.a-Z f rta rem uM)
CONSTRUCTION INFORMATI,ON.. .
itionawortoa eormeuner this permit–check all appy:
HVAC be
Tank []Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: I./-A S . Ft.of First Floor. //d
Cost of Construction:$ a,�r Utilities: Ll Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Namel6mvPPs. 116?
Name: 3&W e-
Address: Company:
City:farl�ierr� State:AFX Address:
Zip Code:3'94 , Fax: City: State:
Phone No.C15,1- 41 CI Q-•19AL Zip Code: Fax:
E-Mail: rl- Phone No.
Fill in fee simple Title Holder on next pag (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.
-SUPPLEMENTAL CONSTRUCTIONTLIEN^LAW-INFORMATION:---
DESIGNER/ENGINEER: XNdt Applicable MORTGAGE COMPANY: Not Applicable
Name: io � Name: - w'iiutga 11h
.
Address: Address: t
t�
City: State: City: g�
State:Or—_
Zip: Phone Zip: Phone: !J% �jG�Y 5D6�
FEE SIMPLE TITLE HOLDER: —Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address,
�a--mt1,g Address:
City:Jr.-s-ink -Are— FL City:
Zip:�Tg _Phone:a,&,,.�-!9!97-14(,A 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 our Notice of Commencement.
Si .. rew�wnL*---Lessee/ tractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDASTATE OF FLORIDA
COUNTY OF t IL
8k COUNTY OF
The fgqrgoing ins ent was acknowledged befor r"' The forgoing instrument was acknowledged before me
this /6 day of 20/3.by this day of 20_ by
I-PC ( A &AI n c,r Q O
Name of person akiqfi statement a 5 r.= Name of person making statement
Personally Known Produced Identifica Z M 5; �Personally Known OR Produced Identification
fe Type of Ide i is ion z = Type of Identification
Produced # Produced
_��Cwj A
V
(Signature of ary u lic-State of Flo ida (Signature of Notary Public-State of Florida)
Commission No. (Seal) Commission No. . (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17