HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I
Date: 1� )3 • I ri Permit Number:
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Building Permit Application DEC 3Q;�
Planning and Development Services
Building and Code Regulation Division. PERYj iTTINIG
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucia Ccu,,tl% FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential 2
PERMIT APPLICATION FOR: Building
Address: lQ �0 d,e��1G�i
Legal Description: LAKEWOOD PARK -UNIT 10- BLK 121 LOT 19 (MAP' 13/01S) (OR 3990-239)
Property Tax ID.#: Parcel ID # 1301-612-0072-000-1
Site Plan Name:
Project Name: Detached Metal Garage
Setbacks Front Back: 15 ft Right Side: 7 1/2 ft Left.Side: 7 1/2 ft
s� .
Lot No. 19
Block No. 121
Form and pour concrete turn down slab, 20 ft x 30 fit; -with 12" x 12" footer with rebar and 6x6 mesh.
Install prefab, metal -garage building. No electric.. Z p o r-i , oncp2 4,:z
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Additional work to be nertormed under this permit — check all mal apply:
❑HVAC L_J Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
❑ Electric ElPlumbing ❑Sprinklers ❑ Generator ❑✓� Roof 5/12 Roof pitch
Total Sq. Ft of Construction: 600 S . Ft. of First Floor: 600
Cost of Construction: $ $8,000.00 Utilities:11Sewer ❑Septic Building Height: 12 it
OW,N,ER%LESSEE-
CONTRACTOR � >
Name Melissa A. Miller
Name:
Address:6603 Pensacola Rd.
Company:
Address:
City: Fort Pierce State: FL
City: State:
Zip Code: 34951 Fax:
Phone No. 1 772 607 1061
Zip Code: Fax:
E-Mail. evolution5109@yahoo.com
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License:
If value of construction.is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not'Applicable MORTGAGE COMPANY: _ Not Applicable
N am e: Melissa A. Miller Name:
Address: Address: 6603 Pensacola Rd.
City: Fort Pierce State: FIL City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
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-9
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
commencine work or recording vour Notice of Commencement.
Signature of 0 er/ Lessee/Co tractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF 1(',1'E
COUNTY OF
The fo.going ins ument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of 204 by
this day of 20_ by
moJ-, ssig Mi UP'Ef'
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification A
Personally Known OR Produced Identification
Type of Iden d ation
Type of Identification
Produced •
Produced
iToiInw--_
(of Notary Public- S1
ture of Notary Public -State of Florida )
KAREN S. NIELS
Commission No.
mmission # FF 11
•Se
6 7
C�om
fission No. (Seal)
y Commission Exp
res
0i1`°PLO June 12, 2018
nru,�ao.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17 N N