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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE.INFO-MUST BE COMPLETED:FOKAPPLICATION TO BEACCEPTED. Date: ,7 j _ ._... . .- _Permit Number: J.O s? _ RECEIVES Building..Permit_.Applicat.- ,n_r.. SUN 2..5 2019 Planning and Development Services - - Building-and Code Regulation Division - - - ST:Lucie County, Permitting 2300-Virginia Avenue;-Fort Pierce FL 34982 - - Phone: (772)-462-1553...Fax: (772),462-1578 ' - Commeecial- -Residential- - - PERMITAPPLICATION FOR: :,. . .. . .. _:, . Q :S ► Address: �.�'. Q iii __..... .. ., .. ji :Legal Description: Property Tax ID#.:,,.-3y`-q me 'lb `a yy�- 000 rt :Lot No: 13- , Site Plan Name: . _ _ ., .. Block No.• Project Name: �A11'lif2 6 �(/C Fe,�e�._. . G+/h)�2, s'y� PUSC3 �n�g- ,ce Setbacks Front Back: Right Side: Left Side: C t�lh5-�i-- 16 . roe-:. r e,jee. ¢',-o.•y, _ fid_-so;� i��'- %off � �2un��_1n���--- . - ---- - � " �o UL' fieri Lvr-� �� oi1e.S�' o /D'°' [.�` l� w 7e° onal work to be performed ;,under this permit cheMall tat appy: ; Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing --Sprinklers - Generator - b- .Roof -Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: -Cost of Construction:$ Utilities:: _Sewer _Septic Building Height:: i Name ['.e urw o`CW1A©ir Name: Address: 33 a Yo` - - - Company: City: ole L u Gam- ' ' -State:FL _ Address t Zip-Code:#Oci y Fax: ._ _ r City: State: ; , Phone„No. 6— 6'7�'1 Zip Code: Fax: ' E-Mail: S .hov ,f rix,2, C-0 b," Phone No ' Fill in fee siinple-Title Holder-on next page(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. aa DESIGNER/ENGINEER: —Not Applicable: ., .-�J,MORTGAGE-CQQMPANY:',t'._'I __Not Applicable Name: Name: C HALPE Address: ___-. . _ ._,__- Address: A o, ,k- %0 f p2/ City: State: City: L o 0 14 QiUJF— State Zip: Phone Zip:yba 90 Phone: B.Oo 8 Q61_ 914,?6� 'z FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _Not Applicable;: Name: i.Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/CONTRACTOR AFFIDVIT-Applicatiori-is hereby made to obtain a permit to do the work and installation as indicated. 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 plansi-the Florida-Building Codes and-St-.-Lucie County Amendments-.-- y' The-following building-permit applications are-exempt from undergoing a-full.concurrency.review:.room additions, is ;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 improvements tojyour property.A Notice-of Commencement-must-be recorded-and-posted..on. site before the first inspection. If you intend to obtain financing,consult with lender or an attorney=-, commencingwork or recording our Notice-of Commencement. Ae, Signatur f Owner/Lessee/Contractor as Agent for.Owner- - Signature-of Contractor/License Holder- - STATE-OF FLORIDA \. STATE OF FLORIDA - COUNTY OF COUNTY OF The fr oing instru ent was_acknowledge efore.me_--. _. The forgoinginstrumentwas acknowledged before me_ ; this day of d nl_,20 4by this day of ,20_ by (Nam -of(Nami-of person acknowledging] _.i_ _' ~? `' .(Name of.person acknowledging], i (Signature of Nota ublic-Sta a of Flor' a) - (Signature:of-Notary Public-State of Florida) Personally Known _ OR Produced Identification Personally Known ----OR Produced'Identification ' .::�I + t; " Type of.ldentification Type-of_Identificati `n::_. .j.: •R- ...>-' . --- Produced _.ed .-_ ti YPV, KAREN,S:-;NIELSE - •--- - -- -- - - --- _ Commission No., _° cgpf.Florida-Notary ' Pu iia mission No. (Seal) Pmrfiission # GG 2074E4 _...._... oP:- .My Commission'Ezpi;r'e' ll 11 l\\\ REVIEWS FRONT ZONING SUPERVISOR' PLANS ,VEGETATION SEA TURTLE MANGROVE,. : COUNTER REVIEW REVIEW REVIEW REVIEW -"" - REVIEW -•`-REVIEW- DATE RECEIVED - t DATE - COMPLETED ;r ,ivw' - :P�+,_ ;tit;ii Fia+"S, `"l� :J '-. fi •-.+1i __.a ..f C7;'t. 1 ;.E�.,y r :v'`'i,? 1 ._ _. i. ,