HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: (�''f�'���]��) Permit Number:
St Lucle CCU*
.. . RECEIVED
Building Permit Application
Planning and Development Services FEB. 0 6 2018
Building and Code Regulation Division perrriittin`g Department
2300 Virginia Avenue, Fort Pierce FL 34982 �sf. a ounty
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR:
Address: d f l?
Legal Description:
ot
-3S�lS�'
PropertyTax ID #: �� O� -S'6/� /d % /�-_,�QB -7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
'DETAILED DESCRIPTION` OF WORK.:° ,. a
x
CONSTRUCTION INFORMATION
Additions I work to be peff-or-m—ea under this permit - Check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator Zoof Pitch
Total Sq. Ft of Construction: �3a
Cost of Construction: $ .3 d?O 0 • O 0
Sq. Ft. of First Floor:
Utilities: Sewer _Septic
Building Height:
OWNER/LESSEE.;
CONTRACTOR;
Name f1Q a 9- 5cf-5,q ►/ f�A&..*IV 5
Name: P-k ' C!14 Rey
Company:JLc ,'fC�¢. -ZS Nd Roa .'w
Address: -F0
City: af,&+ Ae,,&- G•-. State: }
Address: //90f X
Zip Coder SFr?S'7 Fax:
City: 140,6e Soec�.voL State: /—L
Phone No. �U F ' �7 �%/J"�{
Zip Code: YYe1 r- s' Fax:
E-Mail:
Phone No 770"ay/-37a7
Fill in fee simple Title Holder on next page ( if different
E-Mail" o % j6,eAt e. d /Dd (Jh��i"A�.99 �• LOJ!!
from the Owner listed above)
State or County License , e e- Igo ?G 3/
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
NEER:
App
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE -TITLE HOLDER: Not Applicable
Name: _A4.444/ % 5 e4 "Re-,e- 1,ov5
Address:.; S
City:__7y#-s'7
Zip: ryrq,s9 Phone:.sbS-1�F9%��
MORTGAGE COMPANY:,
_/Not Applicable
Name:
Address: ` i
City:
State:
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 rep resentation. 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; iri"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 fromundergoing a full con.currency 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
commencing; work or recording vour'Notice of Commencement.
Signature of Contractor/License Holder
Signature of Owne essee/Contractor as,Agent for Owner ..
STATE OF FLORIDA I
COUNTY OF �on,-i
STATE OF FLORIDA,. '' I
COUNTY OF
,-,
The f rgoing instr nt was acknowledg before me
this day 20 by
The for oing instrttrrrept was acknowledg before me
this day b 20� by
of o
of �J .Qi ,
Ran/,t�
(Name of perso a nowledging)
(Name of person acknowledging)
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of -Florida )
Personally Known OR Produced Identification V--"
Personally, Known OR Produced Identification
Type of Ide ification
L "
Type of Identification
ProduFed as"CkU-J.�
Produced
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Commission No.. 2ZZ ( CEY CABRERA
`"°" EY CABREDA
Commission No.� aQy,� (�RA
assiON # FF982221
n"`/
dw my cobIIvII8sI0N # FF982221
as :EXPIRES: April 13, 2020
Iv¢
a�Y EXPIRES: Apt4�13, 2020
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2 _ 27-�;
DATE
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