HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q /��/
Date: �•I U i1 • Permit Number: /1 I 0
,r 1 RECEIVED
a �..
Now
Buil'n���t Applicatio JAN 30 2018
Planning and Development Services ST. Lucie county, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residential_
PERMIT APPLICATION FOR:
`p.R'f1q(1"SFCl.I(�IfR.kOUfi: FNT1'0rATI N... : .
Address: n G i s -FfW(f V L/C_
Legal Description: S ✓a� l u � - ��-i 10e) 13) K ( 7 1, LA )
Property Tax ID #: 3q 2 S _ 7 D 2 - 6 l ? 7 -pod- 8 Lot No. I
Site Plan Name: 194 Block No. '
Project Name: Qc-cfL
Setbacks Front Back: ZS r Right Side: Left Side:
)ESCRIRTIOIV �OF WQRK �_ 3
Zo l`'la9`-( 7 1 2 v
' A/ s 1� boa G s �o �e r �� �v' fu c e - 9Fvau ws
_Mechanical _Gas Tank `_ Gas Piping
appiy:
_ Shutters
Electric ..Plumbing Sprinklers _ Generator
Total Sq. Ft of Construction:. 1 Sq. Ft. of First Floor:.,'. -
Cost of Construction: $ Jg Utilities: _ Sewer _ Septic
Windows/D'odrs
Roof Pitch
Building Height:_
CiUUNER/LESSEE to
.
Ct31yTRACTOR.
Name S S
Name:
Address2w d
Company: OTC Cd'-«°-�
MS S U C
ppOL214
City: 40 l.e>C.(,t Stater-
Address: 8200 Cs--C
Zip Code: gf-1 7.5"Z Fax:
City: 6W i
State-rz
Phone No. 772 Z 16 - 10"1G
Zip Code: 3k i g�'? fax:
E-Mail: '
Phone No 77Z —.2/G - ! 3 4
Fill in fee simple Title Holder on next page ( if different
E-Mail ;!� :I Ve enck•te-•
Olt,5 o(. Cow
from the Owner listed above)
State or County License 2$yl l
If value of construction is.2500 or more, a RECORDED Notice of Commencement is required.
GINEER" - _ Not Applicable
Name:
Address:
City: State:
Zip: i Phone
FEE:SIMPLE TITLE, HOLDEI
Name:
Address:
City:
Zip: Phone:
Not Applicable
OWNER[ CONTRACTOR AFFIDVIT:.Application is
I certify that no work. or installation has commenced pr
St. Lucie County makes no representation that is grantir
which is in conflict with any applicable Home_ Owners A!
structure. Please consult with your Home Owners Assoc
In consideration of the granting of this r�quested permi
in accordance with the approved plans, the Florida Builc
MORTGAGE COMPANY:
_ Not Applicable
Name:
Address:
:City:
State:
Zip: Phone:
BONDING COMPANY:
_Not Applicable
Name:
Address:
City:
Zip: Phone:
iereby made to,obtaima permit to do the work and installation as indicated.
it to the issuance of a permit.
a permit� will authorize the permit holder to build the subject structure
ociatidn rLles, bylaws or and covenants that may restrict or prohibit such
ition and review your deed for any restrictions which may apply.
I do hereby agree that'l will, in all respects, perform the work
ng 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. Ifyou intend to obtain financing, consult with lender r an attorney before
commencing work c�°,re� il4y,our Notice ofICommencement. /,., 7
Signature of O ner Lessee/Contractor as Agent for Owner
Signatur f Contractor/Licen
STATE OF FLORIDA
STAT OF FLORIDA
COUNTY OF l
COUNTY OF
`ment
The foing instru ent was acknowledged efore m
this �/J day of 20 by
The f oing instr was acknowledge efore me
this Q day of 20 0 by
AR K, 3W ac 1
(Name of person acknowledging)
13# R. K
(Name of person acknowledging)
-0
(Sign 'ure of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identificati
L L
Type of Identific
Produced
.Produced
IELSEN
Commission No.
- Commission N FF 1 7
Commission '` *_
KA E'N S. NIELSEN
mission xpir s
F"���"` June 12, 2018
=r°� Commission # FF
15637
REVIEWS
'--�qlf OF f�
FRO "to 0,
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nO
it 6
PLANS
VEGETATION
SEA TURTLE
MANGROVE
REVIEW
REVIEW'
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 7/2014