HomeMy WebLinkAboutBuilding Permit Application.All APPLICABL9 INFO MUST BE COMPL_,_: 4�) FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
l
Building Permit Applic
1703,03yeo
Planning and Development Services " ""
Building and Code Regulation Division BY.
- 2300 Virginia Avenue, Fort -Pierce FL 34982-- - ----
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential _
PERMIT APPLICATION FOR:
Address:
Legal Description: L4
i <-- FL 3 g 9 S
n-p M A -(" � L. a h d I V) G _1-%A & ReS e h
aCcGrct i n Q4-6 PILL BO-D k 30, i0aae S `? and q- Fl h r records a 4= �t Luei c ��! 0�1
Property Tax ID #: 33 —II � l �z, 4" [� :3 o ®O.� Lot No. �o
Site Plan Name:. M a is k L agne I a A a+4 e_ It c° s eYy e. P k a S e n Y) e Block No.
Project Name: M a S-�er E3 C-1+h ID II
Setbacks Front Back: Right Side: Left Side: Q pU;V1d:y dYSI&YVe-�
Additional worK to De perrormea unaer inis permt — cnecK au mat apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutter`s` Windows/Doors"
Electric Plumbing _ Sprinklers _ Generator _ _ Roof Pitch
1
Total Sq. Ft of Construction: �,� it. Sq. Ft. of First Floor•!,y3.5.
Cost of Construction: $ L Cd 0 Utilities: —Sewer —Septic, Building Height:,,
Name G3 VAI J_- 0,Yla L a- E � b Name:
Address: 3 Mar eCYaCe Company:
City: Por lLu0 i e. State:,.F.�- `Address:'
Zip Code: 3 401 � , [ Fax: / City:
Phone No. is b oZ a �`T- Jr �h D L y h �-_ Zip Code:
E-Mail: h yv� 2- iD y e.` b Ja Q COX 6 n si- Phone No
Fill in fee simple Title Holder on next page ( if different E-Mail
from the Owner listed above) State or County License_
J
State:
Fax:
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:„ Not Applicable
Name:
Address: -'
State:
Zip: Phone:;
r`
FEE SIMPLE TITLE HOLDER: Not Applicable
Name: -
Address: - - - -
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
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 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.
(Sig—nitAre of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF-FLOg�l�A'' . ' , `• '• - ';
STATE OF FLORIDA
TY
COUNOF l, I iy V7 \,\, A S
`
COUNTY OF
The forgoing instru ent was acknowledged before me
The forgoing instrument was acknowledged before me
this � day of V 20A by .
this day of , 20_ by .
L-1PJt>,4 ie iO./✓
(Name of person acknowledging)
(Name of person acknowledging)
(Signature of ryPublic- State of Florida)
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced 1, „•„
GEORGE SHEETS
Produced
:..'
;. MY COMMISSION # FF 935296
Commission No. a E01313t) November 11, 2019
Commis n No.. (Seal)
Bonded Thru Notary Public Underwriters
REVIEWS
FRONT
ZONING
SUPERVISOR
P
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 7/ZU14