HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONII APPLICABLE INFO MUST BE CON.
Date:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
411 APPLICATION TO BE ACCEPTED
Permit Number:
WANNER
_ de Count%
Building Permit Applicat
I
Residential
I PERMIT APPLICATION FOR: (LC �U r S 1 C LC
�O 1- O�Ia,CS
RECEIVED
JAN .10 2018
),n Lucie County, Permitting
Address: "5403 OLEA-N D1E-:t2 A-V•i✓ 1 FtI`El al E12C(F/ i L, 3LI`f (32
Legal Description: W4q )n GI TU •7 S 2� 3 FT O �-- N lb0 .(6�) FT 0 F L' 1 SO r-T
OF S 2Ce2.s P—r OF QU-rL-OT 8 ( O.z� A-C� L09 WP5 -1905)
Property Tax ID #: �3q og - 6b) -p 5S S - 060 -Z
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
Lot No.
Block No.
U00\4E C-Y)ST1N6 a00-F
INSTALL ?01-13 TA4 PA-P'0e LQ 11-1-f -In K)--FA-9 S. ItyS-rA LA- Ow ENS Co I2r) I UC-7
_Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator 1/_/Roof.
Total Sq. Ft of Construction: 5 (0 S�j - Sq. Ft. of First Floor:
-Cost of Construction: $ I 2 Utilities: _ Sewer _ Septic Building Height: /
Name .0 C�ILA L, C r,-
Name: "SC-FF -H A M PSQN
Address: 54D%> Gl 6AIQ DE1Q Ay e
Company: ST LLIC 1 e IZcz ri- 11-1 C1
City: 1%T ' 91 E 12Cry State: Fl,
Address: I 13 S (,u i Yn P"CO �0
Zip Code: 3LP02 Fax:
City: PU12T ('T wc,16- State: rL-
PhoneNo.'712-001- S(PO9
Zip Code: 3I)CI'�4 ' Fax: ']-7Z-aU7-737,44
E-Mail:
Phone No'1'I2- 3q4--719
Fill in fee simple Title Holder on next page ( if different
E-Mai1�TU,iG 2C{� 1= I NCa �� A 1-100 • Co
from the Owner listed above)
State or County License (,CC 1 9,,? Co 8 I (P
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
EER: _ Not Ap
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
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 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 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 financine. consult with Ipndpr nr an att„rna , hnf„ro
work or
Signature of Ow / Lessee/Agent
STATE OF COUNTY OF FLORIDA � L U cyL(
of Commencement.
The s�Toing instrument was acknowledged me
this ��ff`�� day of ��i� . 20 l by
ic TC i Hc�,lnn
(Name of person acknowle Bing )
1
(Signature of Nota=OR
Public-to of Flori )
Personally Known Produced Identification
Type of Identification
Produced
Commission No. MY COMMISPJ@MP FF 160517
..., � EXPIRES September 16, 2018
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
DATE
RECEIVED
COMPLETED
Signature of C n ractor/License Holder
STATE OF FLORIDA
COUNTY OF_ CZ�,t
The forgoing instruknent.was acknowledged §efore me
this 5L--" day of a n 20 ?by
(Name of person ack owledging )
(Signature of Notary Public- State of Florid ) 1
Personally Known Produced Produced Identification
Type of Identification
COMM1q,,,J PR,",,,LX
Commission No. pIRES l$ FF t6g51'
e septerp yer 16, 2018 Notes n. .
PLANS //I VEGETATION I SEA TURTLE. I MANGROVE
,EVIEVj REVIEW REVIEW REVIEW