HomeMy WebLinkAboutBuilding Permit Application 7-18-17All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. Permit Number:
R E C El IV E 13
Building Permit Application JUL .18
Planning and Development Services P E
Building and Code Regulation Division St- Lucie Co.
2300 Virginia Avenue, Fort Pierce FL 34982FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR:
*T0
110 1, kit " I � WIP
Address: 'k?03 R) E t-3 r- P 1
Legal Description: +12.,,-1
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PropertyTax ID #: L--b 3 4- 52 2- - COD/ '4 - - I - Lot No.
;Site Plan Name: (, UA,,I2Dtt1L-)0_Q Block No. U
Project Name: NS CZl
Setbacks Front Back: Right Side: C> Left Side:
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PA, I
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Mechanical Gas Tank Gas Piping
Electric Plumbing Sprinklers
Total Sq. Ft of Construction: 2-4 D Sq
Cost of Construction: $ ?>"r2 4>O Utilities:
Name &W> lAk�IDOLOCX-12 &iZJ>(
Address: tpll
City: State: t7 t
ZipCode: Fax:
Phone No. 6_&1—Z06—Z0Z-z>
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Shutters' *:�, i-1
Wiindows/Doors
I-4:
i..
-.,
I Generator-";.' _Roof
F�t �ofirst Floor:
Sewer — Septic
Building Height:
Name:__t
Company:
Address Yc5jQ & < I LZ 1-n
City: 12r I e e6 c_-, - State:jek
Zip CodeAY92Z. ' Fax: L46 5
Phone No -5-'- 'e)7 66
E-Mail _,dAJ JC1Uqa A
State or County License _C°Fel.'11415-Awz_
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If value of construction is 2500 or more, a RECORDED Notice of Commencement, is -required.
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE;TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
7 J
MORTGAGE COMPANY: _ Not Applicable
Name: -�
Address:
City: State: i
zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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 concurl'ency 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
m comencing work or recordinr? vour Notice of Commencement.
f4ignature of Contractor/License Holder
Sigg er of Qw /AgendkTMAewttractor
STATE OF FLORI A
STATE OF FLORI�y�' I
COUNTY OF 2
COUNTY OF
The forgoing instrument was acknowledged before me
The for oing instrument was acknowledged before me
this may of �l�t t) , 20J by
this day of 20/-7by
T r A✓
(Name of person acknowledging)
me o er c ,g �,Orp{ijISS10n # G6060876
�� "� Expires: ,)anuary 8
Bonded thru Aa<on Notary
ignature of Nota ic- State of Florida )
ignature of Notary Public- State of Florida)
Personally Known OR Produced Identification
Personally Known OR Produced Identification
_Z
Type of Identification
Type of Identificatio
Produced fE62 �100370
Produced-
^4irRt�
COMMlSS10 ch1
Commission.(Seal)
2018
Commission No. EX�so I�` Serv1CQ5
Bob
REVIEWS
FRONT`
-ZONING
SUPERVISOR
PLANS' "
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
6�6
RECEIVED
DATE
COMPLETED,`-
1
ev.