HomeMy WebLinkAboutBuilding Permit Application I
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _
Date: Permit Number:
RECEIVED
Building Permit Application OCT 0 4 2017
Planning and Development Services PERMITTING
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
- Commercial Residential
Phone: 772 462 1553 Fax: 772 462 1578 C
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPSED,I(VIPROVEMENT LOCATION k `
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Address: U ALL Zed /g 'POJ-t-s�L�s�-/=� 3�9�
Legal Description: -&14 �Li, �P/q - P Q sz'�r�° I-/l �/1 Z4 y'
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Property Tax ID#: 3 L/�5- �0 S�- DOS-D i?O O - 3 Lot No.
Site Plan Name: Block No.
Project Name: = �'
i Setbacks Front . 00 Back: Right Side: �/�.:��Left Side:
DETAILED DESCRIPTION dF WORK k,
Rec f 61i�f 0r-� 041n4 eo( f�-C ��4�P, Cq.�e- ;442 f Ori
CONSTRUCTItN INFORMATION
r... ,n.... _. .
Add
itiona wor to a er forme under this permit-check a l apply:
[1HVAC E]Gas Tank Gas Piping _Shutters Windows/Doors
❑_Electric ❑_Plumbing 11 Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Constructio • !�o S . Ft.of First Floor:
00
Cost of Construction:$ aI Q O Utilities. _Sewer[]Septic Building Height:
0,1NNE,ft/LES5EE
.;�
CONTRACTOR
Name Name: 5ie-y P 2e --.,,eP
Address: a Company: /'1 U ealiisf/-uc/-i'eN
City: /far4- 5-, Lue;,f Stater Address: .3 �/'E: C"a,Ju 17r,`ri� d"A
Zip Code: 3�!^�.S Fax: City: &4- �t Lt(Gi`-P_ State:
Phone No. 771) - Za y� � � Zip Code: 3W 9 Fax: 77U °-3Y0-eO �2
E-Mail: Phone No. 77a- My 3
Fill in fee simple Title Holder on next page(if different E-Mail: 3-f-e-yev P� �A od CDC
from the Owner listed above) State or County License: ,--,R / 331014 y::
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
v • "017-10-03 14:10 Savanna C' HOA 7723400522 >> -1 P 1/1
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S.UPPLEIVI.ElV7AL'CON57R.U.CT1lJN:LI: N_LAW lN•FORMAT.:.I.ON •: ::_: ,.
1 - - -DESIGNER/ENG VEER• - - NO)Applicable MORTGAGE COMPANY: _Not Applicable
Name: 1 C Q a Name: '
Address; c, e Address: I
City: State: City: State;
-Zp:��j Ar=g— -Phone— 3'�(o r/y _ -Zip-.—Phone:
i
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: —Not Applicable
Name: Name:
Address; Address:
City: City:
Zip; Phone; Zip: Phone:
j -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 subicet 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,1 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 b corded and posted on the jobsite
before the f 'nspection.If yo 'ntend to obtain financing,consult it lender or an a ney before
corrimencift w rk or recordin ur Notice of Commence men
I
Signature tf Owner/Lessee/Contr for as Agent for Owner Signature of tractor/License H der
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF V.40, COUNTY OF'Vc-1t>~c��-
The for�ggoing Instrument was acknowledged before me The forgoing instrument was acknowledged before me
this'Today of 004 e�,20�by this r3 day of CSc�cu W _201-7 by
Name of person making statement Name of person making statement
Personally Known OR Produced Identification l/ PersonallyTpe of Known OR Produced Identification__t/
Type Identifi t�n M Pr aJod ced T L-�c io
Producc ed K3 G
i
�gnature Public- of Florida) (signature Notary Publyicc-Kate of=) EXPOIRE
, NCommission Nd�" UE� ��,��, r o mission No. SIo OpE239
ob112,2021MY COMMISS 03g N
WYIP51 CA
REVIEWS FRONT NS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE ®�
117
RECEIVED ��
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--DATE ---- _._. --------- --._. ----_--- -- - -- �G -- ---------------— -- --------- --- -------- ----- ------
COMPLETED ro
Rev.8/2/17
.01MIGUEL NAPOLES
�'i MY COMMISSION p 00072039