HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO UST BE COMPLETIL _'DR APPLICATION TO BE ACCEPTED _
Date: Permit Number: a'a�1'�
SCANNED
Lucie Cauv RECEI 0
Building Permit AppkiltiorfEB 12 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: V, 4 Q � 1
Address:
Legal Description:
If0S1' _Q
R
3g�7 afar
Property Tax ID ##: ��� 1� Lot No.-�
Site Plan Name: Block No. ---
Project Name:
Setbacks Front Back: Right Side: Left Side:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _Plumbing _Sprinklers _ Generator t/1oof Gc Pitch
Total Sq. Ft of Construction: 00 Sq. Ft. of First Floor:
Cost of Construction: $ f �� • 00 Utilities: —Sewer _ Septic Building Height:
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
INEER: _ Not Applica
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 financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
ell
Signs re of Owner/ Lessee tractor as Agent for Owner
Signature of C ntractor/License Hold 19
STATE OF FLORIDA
STATE OF FLORIDA 2 1
COUNTY OF �1�� ��
COUNTY OF `1 1 r 2,
The forg ing instrument was acknowledged before me
The forgoing instru �n was acknowledged before me
this hay of , 20by
this 1' tlay of 20, f� by
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(Name of person acknowledging)
(Name of person acknowledging
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to of ride)
(Signat a of Pota.ry =OR
(Signature of otary Public- S e of Florida )
Personally Known ProducedIdentification
Stephen P. Frederick
Personally Known OR Pr ucedMWq2tjMedck
°t�As
Type of Identification t ►'
Type of Identification �. NOTARY PUBLJC
Produced civi NOTARY PUBLIC
Produced ATE OF FLORIDA
-�STATE OF FLORIDA
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Comm# GG048393
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Commission Na. Expires 021
Commission No. E�§99 1/27/2021
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
(G
DATE
COMPLETED
27
ev.
WA