HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ,•� p
Date: O 24• %7 Permit Number:
- Building Permit Application gUGu2 9 2017
Planning and Development Services
Building and Code Regulation Division
Property Tax ID #: 3 � I Y ,, S0 1 • 1 /0(9 . 100, 9 Lot No._�_
Site Plan Name: II Block No. 3
Project Name: r O;EIN WG lC �S �' CNCC
Setbacks Front /5 _ Back: /45 Right Side: 3• Left Side: �• ,
4
W/ P/ P C- -t-r i rZItf '1- 4--) 1 u m J-, i n A.
Additional work to be pertormed under tnis permit— cneCk all tnat apply:
_Mechanical _ Gas Tank JS
Gas Piping _Shutters eWindows/Doors
�ectric _Plumbingprinklers _ Generator �oof 4 Pi h
Total Sq. Ft of Construction: ��� 3 Sq. Ft. of First Floor:
Cost of Construction: $ CQ060C Utilities: —Sewer _Septic Building Height:
Name 1,-2 �=- �43A.)14 j?et1 d Name: f" o
Address: 7 "l w 1' c)4 • AC-6' Company:
City: PS L-- State: 1—L',-C Address:
Zip Code: 3 1 of S.2, Fax: City:
Phone No. %.� " 66 3 Zip Code:
E-Mail: r tit.06 tdl, :PepXt Wi Phone No
Fill in fee i ple Title Holder on next page ( if dill n04t E-Mail
from the Owner listed above) State or County License,
Fax:
State:
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
=P000 'ENTAL CONS RU
ION kN LAW [NFORMA
IO
DESIGNER/ENGINEER:
Name: +
Not Applicable
+e~ �1 S
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: aS ) i &-s V4RA
City: A,Q C. t
i b fk iyG
jState: jc'!
Address:
City: State:
Zip: .'2:� S1 1 Phone ')-7.%�'771/0
0S(o
l
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _No
t Applicable
BONDING COMPANY: Not Applicable
Name:
1
Name:
Address:
i
Address:
City:
City:
;
Zip: Phone:
Zip: Phone: i
9
OWNER/ CONTRACTOR AFFIDVIT: Application is' herby made fo'obtain 'a permit to do the work and installation as indicated.
I certify that no work or installation has comm 9 nced prior to the issuance of a permit.
St. Lucie,County makes no representation that is granting a permit wilLauthorize therpermit holder to build the subject'structure
which is in conflict with 'any applicable Home..Owne'rs A' ssociation,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'ade a that I will, in all, respects, perform the work
in accordance with the approved plans, the Flo {ida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full, concurreney review: room additions,
accessory structures, swimming pools, fences, %61s, signs; screen rooms and accessory uses to an6&r� non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your .p perty. A Notice of Commencement must;be recorded and posted on the jobsite
before the first inspecti n. If you intend to obtain financing, consult with° lender or an attorney before
commencinoMoKor Ocorftgyour Notice ofrC'ommilencement.
SignYature of Own. erl�essee/Contractor as.Agent,fo �
STATE OF FLORID
COUNTY OF
za
The f ing instrument was acknowledge fl efore o
this day
T �
a �T2
0 17 u) C,r-A OD11) e-n W 0 pil
(Name of person acknowledging )
(Signature of goPu61 c- State of Florida) 9 "
Personally Known OR Produced Identificati
Type of denti ' ation
Produced
Commission (Seal) `
.;Signature_of.Contractor/License Holder•
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this day of . 20_ by
(Name of person acknowledging )
(Signature of Notary -Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification
,,Produced
CommissionNo!
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION,
SEA TURTLE ,"
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW'- "
-REVIEW
REVIEW
DATE
RECEIVEDI)
h
DATE
COMPLETED
RCv. //LU14