HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONf
1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ! SCANNED Permit Number:BY
. "XI -'.lf wn.AA+.-Rv St Luck) c®Nrl`1
s RECEIVED
Building Permit Application FEB 15 2018
Planning and Development Services
Permitting men
Building and Code Regulation Division St. Luciea CCounounty
2300 Virginia Avenue, Fort Pierce FL 34982
X
Phone: (772) 462-1553 Fax: (772) 462- 1578 Commercial Residential
PERMIT APPLICATION FOR:
PROPQSED`IMPRQUEMENT
��
IOCAT(QNr' ti
_
Latisx Q
Address:
0
Legal Description: q ��J 4Q, -C-vc'n 00i C.09- CYO 'SG kN Or- QUJ klq
D-W SIN �aa. Gov Oh
Property Tax ID #: d— 1 C)i — �A a lQ0[) — COO — R Lot No.
Site Plan Name: Block No.
ProjectName: i(1'eS �5 �eS��e.YiC,2
Setbacks Front ack: Right Side: Left Side:
l
DETAILED DESCRIPTIONOF1IORK
'�1
,"ll�
'1NSJV0A1 me W o-c-ce sso ?Y rne�a.IS naU rmelml po-nd
CONSTRUCT,ICIN
sIr PAP
aNFrormenNertk,
s�- permi't —S check
Additional work o ply:ap
�HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof LAO Roof pitch
Total Sq. Ft of Construction: .1'00 S , Ft. of First Floor:
11Sewer
Cost of Construction: $ ��., C� Utilities: Septic Building Height: AG
OUIINE%LESSE� ` � r CONTRACTOR:'
Name YY—S
Name: �1uay-) i�1�O►.i; N'CZ
Address: 4^ �1�9—
Company: k st YY1S
City: tjP t-ev2G-e. State: ��,
Address: 3aa\ 5E 1 �rv�c,Q, Tez
Zip Code: � R
p 3 4Bk Fax:q'A 4�j�-9-- 8 - 33
city:
y: �'tC )O►y*
Phone No,q'42- $SD_-8030
_State:'
Zip Code: Fax:
E-Mail: U°1'1'1S i7
Phone No.
E-Mail: 'ZCL
�
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement
is required.
/
SUPPLEaMENTAL CONSTRUCTION LIEN LAIN INI=ORMATION <
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
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 dog 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 vour Notice of Commencement.
I
Owner/
Signatu of Owner/ Lesse ontrac as Agent for Owner
Signatur Contractor/Li se H
S TE OF A
ATE OF FL �^
COUNTY OF
COUNTY O 1 `' \IAC�T�V•�
The for oing ins ent was ackn wledged before me
The forgoing instrument was ack owledged before me
thiTTs day of w 20% by
this\' day of 20—% by
Name of person making statement
Name of Pierson making statement
Personally Known �� OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
'Produced
1
(Signature of Notary Pub State of Florida)
(Signature of Notary P I' -State of Florida )
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVI
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
CO
- -- -
�-lP—
Rev.. BONNIE LOVITT'--"
' MY COMMISSION # GCi143430 MY COMMISSION # GG143438
,+� EXPIRES September 17, 2021
EXPIRES September 17, 2021 •,?fr+,•`�