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Home My WebLink AboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLEX w `rOR APPLICATION TO BE ACCEPTED Datl : �� Permit Number: 0$• AUG 18 Building Permit `Application Planning and Development Services pEr�rvjlrri Building and Code Regulation Division St' Lucie (:ou= F` 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential_ PERMIT APPLICATION FOR: ftP©m INPROVEMENT LOCATION: Address: 161 C L M&v' D,6 z )en, Legal Description: Property Tax ID #: 4S-1l • ( l O • COOS • IOC Lot No. Site Plan Name: Block No. Project Name: 3-ev"9- n-y W kwC l w Ze r�ocl -f.I Setbacks Front Back: Right Side: Left Side: I �/2 ttm . I IQ S eEE- . i S K W kL"_�_ ►? �.rn Z `Jz fvn i f [ cee� i g IL heal ditionai work to be pertormea unaer tnis permit - cnec Mechanical Gas Tank —Gas Piping _ Electric _ Plumbing _ Sprinklers Total Sq. Ft of Construction: g SOD 00 an tnat appiy: Shutters _ Generator Sq. Ft. of First Floor: _ Cost of Construction: $ Utilities: Sewer _ Septic Windows/Doors Roof Pitch Building Height: OWNER/ E�S�SR NNTIKAA_3341101:1111111 Name cJC'z 4 W k't I c✓ Name: K'-c,YM I-L ou Company: 19M J ConcreK Canh-az QCs� jY)c, Address: 57 zo 6"view QySve City: F-t &vo(&-dwLe- State: Address: _-LS-Xg V4i5 Ck Zip Code: Fax: City: O M ('kn )9ze. State: Phone No. Zip Code: 2y cl 7 2 Fax: E-Mail: Phone No�S� Fill in fee simple Title Holder on next page ( if different E-Mail Cz, from the Owner listed above) State or County License n S 8 (0 ) b If value of construction is 2500 or more, a RECORDED.: Notice of Commencement is regwrea. SUPPLEMENTAL C©NST' TION LIEN LAW INFORMATI®N: DESIGNER/ENGINEER:' _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: 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 o'r an attorney before commenring work or recording vour Notice of Commencement. , Signature of Owner/ Lesse C ntractor as Agent for Owner Signature of Contra r/License Holder STATE OF FLORIDA STATE OF FLORID COUNTY OFF COUNTY OF The fo -oing instrument was acknowledged before me this day of 20_0 by The forgoing instrum was acknowledged before me this h( day of 201 by (Name of person acknowledge g) jatur (Name of person acknowledging C��Qr►.fz �. of Notary Public- Stat f Florida) (Signature of Notary Public- ate of Florida ) Identification Personally Known OR Produced Identification Personally Known OR Produced Type of Id icat' ' Type of Identification Produced _ — NGRAM LAShAHIVA o<P °�� Notary Public St a of Florida Commission No z � � e0 2p18 Produced Commission No. ,,��° r,. n SHAHNA Ih�$e .1_ c� 3saa r , °�oP Commission 7, FF 177249 .1 A ion A _ a,•., Notary Public -State of Florida 4 q - = ` u u ° c MV C.nm M Go I REVIEWS tionae(l� rFRONT ZONING SUPERVISOR PLANS b°; V�GE`P°ATIO'IONBon ommission'# FF 177)a leSEAjTttQB1T4Nota y NGROVE COUNTER REVIEW REVIEW REVIEW REVIEW_'-- E W DATE RECEIVED DATE (, Z-911-AL COMPLETED z�_ Rev. 7/2014