HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 5-29-17All APPLICABLE INFO MUST BE COMPLEI1.� ;OR APPLICATION TO BE'ACCEPTED
Date: <jr Permit Number. 0 (Z"o r I
RECEP. _:D jum 2 9 2017
Building permit Application
Planning and Development Services
Building and Code Regulation Division /
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (272) 462-1553 Fax: (772) 462-em8 Commerdai Residential VVV
I PERMIT APPLICATION FOR: NW SVMAt" �66 &4.& ! ee4S`Itj,4 I
Address: 010 K Co.�U
Legal Description: LAROl IWA �_tsr,_1�22`�1�� q Z L0± 11
Property Tan ID #: �3i>� -- �jc �-+d �i `-� Lot No -
Site Plan Name: L-Ar-49(wA PGIk Block No. 7�
Proiect Name:
Setbacks Front Back Bight Side: Left Side:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing. n, Sprinklers _ Generator
Total Sq_ Ft of Construction: _7�b�t Sq_ Ft of First Floor_ —
Cost of Construction: $ 4W -w Utilities: —Sewer _ Septic
If
_ Windows/Doors
Roof
Building Height: to
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Name
Name:
Address:
Compan C, fica
C,
City:
Address:
Zip Code: M44,91 Fax:
City: N CA state-11EL,
Phone No. 7T7 "' - ••
Zip Code: 3 LIG(g Fa7Tz-'335—�.34 ?.
E-Mail:
Phone No %r - 3-3L
Fill in fee simple Title Holder on next page ( if different
E-Mail -ji f Sawb �L°--
from the Owner listed above)
State or County license GAG d.S73
if value of construeffon is ZSUU or more, a REWRU€U Notice ox
is requma.
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IiaESlGfafiER�ENGIi11iEER:
Not Applicable I
MORTGAGE MP
Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
Jzhot 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 insulation has commenced prior to the issuance of a permit_
St Lucie County mattes no representation that is granting a permit will! authorize the permit holder to build the subject structure
which is in eoreflnt wM any app5mWe Home Owaams As§Dziation wPes! li &m s or and covenants the nwV restrict or prohibit such
structure_ Please consult with your Home Owners Association and renew your deed for any restrictions vi ich 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 folloi-Ang building permit applications are exempt from undergoing a full concurrency review room additions,
accessory structures, sreaimming pools, fences, vri,@ls, stater mums and aotxssory uses to another non-residentiial 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 financin& consult with lender or an attorney before
work or
Signature of Owner/ Lessee/Agent
Notice of Commencement.
Holder
STATE OF FLORI A STATE OF FLORIDA
COUNTY OF S�COUNT OIF 5 h � L- U c t -Qz'
The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 5 J y% - , 20_ by this sday of Zy vvk , 204 by
�rZI woy a �- A C 5 I W ov`� . s, L d t e
(Name of person acknowledging) (Name of person acknowledging)
BSignature of Notary Pub e - State of Florida QSi&mturre of Notary Pu lit St a e of Florida �
Personally Known OR Produced Identification Personally Known OR Produced Identification.
Type of Identification Type of Ild
Produced 1. _ Produced ��rk DEANNA MARIE GIVENS
DEANNAMARIE GIVENS
MY COMMISSION # GG 022023
% MY OM ISSION # GG 02020
�rnmi55ion®_ �. December 16, CorrirreissirB Y� ; S� December 1�I�
r " Public Und 02 Aers o e Lary Public underv+dters
r Notary
Bonds Thn
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION [SEATURTLE MANGROVE
1 COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED �