HomeMy WebLinkAboutBuilding Permit Application7--z — YG 9 6 p -7
All APPLICABLE INFO MUST BE COMPLETIrD FOR APPLICATION TO BE ACCEPTED
Date: I d`J It Permit Number: `13
W Building Permit Application' DEC 0 5 2917
Planning and Development Services
Building and Code Regulation Division '
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR:
Address: t1W rOb t '4-orT PI exc e . 30
6j I
yegal Description: O�rk �-�_ rf lot.,(5 k J g ! )• '&0 13 l bV�
PropertyTax lD #: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Haamonai worK to oe perrormea unaer tnis permit-.cnecK aii tnat apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters — Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: 2.12 Uy • . Sq. Ft. of First Floor: _
Cost of Construction: $ 124 g Utilities: —Sewer —Septic Building Height:
01 �RIl.ESSEE:
CONTRACT®R:
Address:'4 DO I t^ i` e'
Name` ►.� f,
Company: cr ' -e- A I�d
CitY: q; I r '': State-•
Zip Code: .J T"fJ Fax:
Phone No. 7% • 4( 4- 9& b i
Address: DA &e-
City: CrU Stat"e� I
Zip Code: 3,:P-C14,,�, Fax: `l70�' � U�� `!•
Phone No
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above) ':.
E-Mail rxo c r'H
State or County License abq CeC l_73:�6°be
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
SURPLEM =�NTAL CQ'NS
RUCTION tl'EN LAW 4011E R M AN 0W.
DESIGNER/ENGINEER:
Name:
Address:
City:
Zip: Phone
Not Applicable
State:
I
I
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
—Not Applicable
BONDING COMPANY: Not Applicable
Name:
Address:
City:
i
Address:
City:
Zip: Phone:
I
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain i-Ormi ito 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 consid'eration of the-grantingof this requested permit,jl do hereby agree that Twill, 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 alNotice 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 vour Notice of Commencement. -.,
I I
1
Signat of 0W' P r/,L'esse7e Contractor as Agent for O�wner
S na ` •' a of Contractor/License Holder,
STATE OF FL R DA _�:`1
STATE R A ..; ORFLO
COUNTY
COUNTY OF
The f ing instr ent was acknowled € me
The f going instru ent was acknowledge) efore me
-before
this, LWday day of 201 r by
thiA - uay of Ak& 20 / 7 by
�0-rmll
dart, m. ,
(Name person acknowledging)
Name of erson acknowledging)
I
> ,.�,/lam • � .
f
(Signatur f Notary Public;.State�,of Florida )
Personally Known OR Produced Identification
(Signatu of Notary Public- SVate of Florida )'
Personally Known �a r4 i g0WI:ion
° :
Type of Identificatio _.: 6- MY COMMISSION#FF238495
Type of Identification
YP
� "'+ �-.
Produced �� ;a, EXPIRES:
Produced •• GUERITEM.ESTOOK
(public Undendriter9
+: MY COMMISSION # FF 238495
Commission.No: (Seal)' '.
Commission No. `•.,, ,.'P EVI & ober5,2019
60ndedT a PubricUnderwriters
REVIEWS
FRONT
ZONING,
SUPERVISOR
PLANS
VEGETATION
SEA.TURTLE
MANGROVE
COUNTER_
REVIEW
.'REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
41^
RECEIVED
DATE
COMPLETED
I
Rev. //ZU14