HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Planning and Development Services
K'Awm r1 Permit Number:
BY,
atLucieCdaok
Building Permit Application RECEIVED
FEB 14 1018
Building and Code Regulation Division
2300 Virginia Avenue, Font Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT APPLICATION FOR: Aluminum with concrete
Address:
Legal Description:
( Department
Residential St.. Luc Lucie County
Property Tax ID #: :5 1i 0 5-- '70 3 ba!Q q -Do 0 - :7 Lot No.�f
Site l�l Plan Name: clecA Block No.
ee�Ao�
Project Name: i IMI(P� 4
Setbacks Front_ Back: Z6 Right Side: �_ Left Side:
;Ird Sc<, 6,0,6UTG �.+ i-e� J/ a0fd94vv1C. ( CaO6 e Ca4wirt
L6c1 e,t -
0HVAC
11 Electric
QWindows/Doors
Plumbing Sprinklers 11 Generator 0 Roof Roof pitch
i
Total Sq. Ft of Construction: I Sq. Ft. of First Floor: i
Cost of Construction: $ l 44 -7 0• 00 Utilities: Sewer Septic Building Height:
01N�hER�ESSE. lq�ll,m��o . Ks l.,tLs3, a�, is� A,CONTACTOR
/'+ ry��'''
r.'•,,
Name 49-aA HA 0 L E DLL
Name:
Address: 3% IF LiD es
Company: 1APRt>q D e/J_1T2 P SS;S J14
City: N I&TPAJ CCAW4-a14 State: O/J
Address: / 7a 8 5T
Zip Code:Lgl— 3G q Fax:
City: i ne r sT- L ue-I F State: rz,_
Phone No.
Zip Code: 349 g Y Fax: 772 -577- d a
E-Mail: btnot 1 O A Cb m
Phone No. 77 V- '5'_% 7- &129)
Fill in fee simple Title Holder on n4 page (if different
E-Mail: Uk5Pn �at brGtn ar-ro a 0zM.4
from the Owner listed above)
state or County License: 0 - v
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPRLEMENTAL CC}N5 7RUCTI,ON LIE,Nr LAW INFORN(ATION
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,: •..
DESIGN ER�/ENGINEER _ Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name. me-f'j G. WaO.D
Name:
Address: Lwo Svv/ SULT?}-nl
Address:
City: Pat / State:
City:
State:
Zip: 3T-9 5-3 Phone 77.7 - 71179 -73ay
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
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
commencin rk or recording ur Notice of Commencement.
l�
Signa ure o Contracto Wens der
sig&tui of see Cont ctor as Agent for Owner
STATE OF FL DA
�, Pi
STATE OF FLORIDA
"Ly'A
COUNTY OF luG'
COUNTY OF -
The forggQ�m�g instryymment was acknowledged before me
this Ja5i of I'tb�ry 20� by
The fo�,r� o.,ing instrum nt was acknowledged, before me
this Lr—day ofy�1 20) V by
,
,
Name of person m g statement
Name of person ng statement
Personally Known OR Produced Identification
Personally Known OR Produced. Identification
Type of Identification
Type of Identification
Produced oe
Produced
(Signature of Notary Public- State of Florida
(Signature of Notary Public- State of Florida
PNDREW GRAS
Commission No = :(Sea
`- MY OMMISSION # FF
O ;p+s ANDREW GIR
ission No�� ''II11
a .`& COMMISSION #
EXPIRES June 02, 2
•30
20 ,. EXPIRES June 0
40 8-0153 Fbrkk Note Service.co
1407 3U4153
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17