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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 1-29-18All APPLICABLE INFO MUST BE COMPLETw"r'aR APPLICATION TO BE ACCEPTED Date: Permit Number: BY RECEIVED . St Lucie Coulity JAN 2 9 20�� Building Permit Applicatio Planning and Development Services ST. Lucie County; i'efig rr�9iW Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 349,82 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: L ;N,,a PRraP©rS.ED tN'PRC}VMf NT LC+:CA'IfN. Address: !'tl d ` r9 6 E LL /u Legal Description: PropertyTaxlD#: '�a��'��l- ei�G6- 040- Lot No. Site Plan Name: << Block No. Project Name: Nufc Sty Setbacks FronBack: Right Side:© a Left Side: Aaaitionai worK to be- perrormea unaer tnis permit — cnecK aii tnat apply: ,Mechanical _ Gas Tank _ Gas Piping _ Shutters% Windows/Doors; Electric Plumbing _ Sprinklers _ Generator Roof Pitch on /� 2 �, Total Sq. Ft of Construction: �1 �� Sq. Ft. of First Floor: Cost of Construction: $ 9f 'Od o Utilities: —Sewer Septic Building Height: 10,14 Name �-36� CAC(_- o 0 Address: � 7 lQ 9 C � lU VC( ( E �lI City: 5— �vC E f Stater Zip Code: Fax: Phone No. 7�3 13 " E-Mail: (?AL ob0_A0F_ 0 0.YY1 AfiL Q4f6 n Fill in fee'simple Title Holder off next page ( if different Name: L-AWJQU Company: e?k-C 4 t— 4-,W_'CJ/U Address:' 50 6' 102c 5i 4i1L« dV City: c z S r Ldcfe State:�L Zips 1` Fax: Phone No 22 -36( -16A E-Mail CGAuI,Saa1 & /_q�cru._n g�m (e,(05 from the Owner listed above) State or County License If value of construction is 2500 or more, a RECORDED Notice of Commencemenf is required. '�UPLE+I�T►�.CCNSTFl3TlEILIAUU� RNITI E 06 .. DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: — Not Applicable Name: , =..:-; . Name: Address: ' Address: City: State, City:; State: Zip: Phone' i Zip: Phone: FEE SIMPL''E TITLE-.HbLDER: _ Not Applicable, BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: I 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 exemptJfrom 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 ins i If you intend to obtain financing, consult with lender or an attorney before commenqngmo re rdin our Notice of Commencement. ign/fifture of Owner/ Lessee/Contractor as Agent for Owner Si nature of Contractor/License Holder STATE OF FLORIDA �. STATE OF FLORIDA COUNTY OF 1 COUNTY OF S A, U 0k The forgoing.instEument was acknowledged before me s�� `� ^ The forgoing instrument was acknowledge before me th day of`3 20 by this�� day of4Y� 20 by �,�. o, � w' � c k► �. dl tiJ Sam I �-ho„�. ,�s � � � Lows 3 � � (Name of person acknowledging) (Name of person acknowledging) i (Signature of Notaryublic- State of Florida) I (Signature of Notary P blic- State of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identificati Type of Identification Type of Identification Produced O 4J� MARIE GIVENS Produced td ••Yp;;.., pEANNAMARIEGIVENS ; �.. ;, MY SIGN # GG 022073 P pEANNA :, ISSION # GG 022023 MY OM Commission No. 5 pecembe4i6.2a2o :;*? �(pIRES: ecembler 16, 2020 1 Commission No., a4llicUnderurite!! }�, Bonded lhruNotarypublicUndenvdters onded7hnit ..� PLANS VEGETATION SEA TURTLE MANGROVE REVIEWS FRONT ZONING SUPERVISOR COUNTER REVIEW REVIEW REVIE REVIEW REVIEW REVIEW DATE RECEIVED DATE I COMPLETED ev. I