HomeMy WebLinkAboutBuilding Permit Package � wDa.�IrLSirtttCl�. ££��CC7N '-.
AlI,APPIICABL INF.O`MUST BE COMPLETED FOWAPRLICATION TO BE ACCEPTED'
:Date; ,. ,
"s Per'rnit,Number:
t0 1
Building;Pen tit Application
f'?arrtMg gnd Development
Buildingcrud Code Re ulatiotr Division _� _.- � �', omrnerclal _- Resrder�flal ._
2200 VIr9tnj6 Avenue Fart Pierce-FL 349S2
Phone.(772)4.6273S53 Fax:(772)462.157�8
PERMITAPPIICATION FOR"
{?ROPQSED"l1V3PRQVEMENT 011ZA, IQN
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Address: `�. J *> : a ,:`,a�� 2 t7a` ko/ 1 .. �
Prciperty Tax lt7##: r e: a <" . � �r`r old, ` Cot No:
Site Plan:Name �' Block NO;
Project Natrie:
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DETAIIED OESCRIPTION OF WQRK
Now Electrical'Meter. Second.Electrical Meter (Affidavit required)
CONSTRUCTION,IN'PORMATIQN
'Additional work to be performed widerthis permit-check all that aPplY-;
_Mechanical' ,-Gas Tank Gas Pioing Shutters: _Windows/Doors Pond
_Electric Plumbing Sprinklers Generator _Roof Pitch
Total Sq:Ft of Construction: Sq.,Ft._of First Floor: .
Cost of Construction:$ -7l x Utilities; _.Sewer. .,Septic. Building•Height:
otnrivE IrEss E colvTRacrOR
Nam Name:
Address: - J f Com an : 14
` L_._.___.� P Y' f
City: .€� State: /ff Address " l``'./ .
:tip Code; ``L Fax: City:r {� 1 State•% ..
Phone No. ? Zip:Code S ' Fax
E-Cvlarl /ref: `�6'a Phone.No 7 S' ?
e.slm le Title Holder on next a e(ff different E-Mail _ c l" ,4 e
Fitt to fe., p . p !� �r e .�', /.
from the Owner fisted above) State or County license 3
If value.of construction is 2500 or rnore;a RECORDEQ Notice of Commencement is:iequired:
If value of'HAVC it$7, 00:or more„a'RECORDED Notice of Cornmencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN !A1l11 INFORMATION:
DESIGNER/ENGINEER.: Not Applicable. MORTGAGE GOMPANYt Not Applicable
Name: Name:
Address• .� Address•.
City: ' State:` _.. City:
Zip: Pho Zip: Phone: .,
State:,
FEE SIMPLE TITLE HOLDER: � Not Applicable BONDING.COMPANY: _Not Applicable
Name:, NAme:
,
Address: Address
City:' City:
Zip., Phoned Zip:: Phone:.
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OWNER/CONTRACTOR AFFIDVIT:Application'ishereby made to.obtain a permit to do fhe,work.and installation as indicated.
I certify that no Work or installation has commenced prior to the issuance of a permit:
SL 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 Homer Owners Association and review your deed for any restrictions which may apply.
ln: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 Coniroencement may result in paying twice for
improvements to:your property..A Notice of Commencement must'be recorded in the public records:of St.
Lucie County 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: ur Notice of Commencement.
Signature of Owner(Lessee/Contractor as:Agent for:Owner
STATE OF FLORIDA
COUNTY'OF z: F
Sworn to:(or affirmed)and;subscribed before me of ti!" Physical Presence or Oniine'Notarization
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Name of person making statement.
Personally Known OR Produced Identification .
Type of Identification Produced 171— 7�.. ..
ignatuCe f Notary Publi&S!�ti of Florida):
Commission No. 'A� 3 02- (Seal)
x ;..
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA,TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
I DATE
RECEIVED
DATE;
COMPLETED _ .
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LOT 31 LOT32
L0T 33
BLOCK 52 . - BLOCK 52. - BLOCK 52
8000
SAC 1J2 r 9 'IRC 1/2'
(0 60i* (l8.6922
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LOT 9
BLOCK 52
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LOT 8: 3.4, yOT ;0
BLOCK .52 BLOCK 5
w. 15202 z o
o ONE-5t6,o' C85 �
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BEARING Lo A
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FIR:SJ$. FSRC 5/$
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tip°.00'00`E _ N0*00TOT Wool
b77,00`
NW CORNER OF
BLOCK 52 M ,
HICKORY DRIVE
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