HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONt
y All APPLICABLE INFO MUST BE COMPLETED FOIZ APPLICATION TO BE ACCEPTED
Permit Number:
Date: -7SCANNED
0020
BY
�� Lurie �otint i
RECEIVED
Building Permit Applicatio MAR 01 Z018
Y
Planning and Development Services
ST. Lucia county, Permltting
Building and Code Regulation Division j
Fort Pierce FL 34982
2300 Virginia Avenue,
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
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PERMIT APPLICATION FOR: LLN0-V1"D (iAcnGJL�
r
PROPOSED INPROVEMER- L®CATION:
4-2!10 '
Address:
Legal Description:
2
oL 1 73d p3,d O U �
Property Tax ID #: / 7 � Z ''LL
Lot No.
Block No.
Site Plan Name:
Project Name:
Back: Right Side: �� s Left Side:
Setbacks Front
DETAILED-DE�SGRI'PTI�ON OF WOR{K.
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i
C®NSl"RUCTION INFORMATION:
itiona wor to be performed un er this permit - check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Windows/Doors
Electric Plumbing _ Sprinklers _ Generator
Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
$ 000 !� Utilities:
Building Height:
Cost of Construction: i —Sewer —Septic
OWNER/CONTRACTOR:
Name 1 AAX--Q I oa Name:
Address: �W Afd Az Company:
City: 1� �`4GL State:�Z
Zip( ode:.3,S Fax: City:
State:
Phone No.7%?-,- K 70 Z Z"7 Zip Code:
Fax:
E-Mail: _bAt/6 dG2owG��oC • Cderl Phone No
r
Fill in fee simple Title Holder on next page ( if different E-Mail
from the Owner listed above) State or County License
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If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:
— Not Applicable;,
Name:
Address:. r.._.
City: State:
Zip: Phone
,,MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
city:, y State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: — Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: 1 Address:
City: 1 City:
Zip: Phone: 1 Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is herebylmade to obtain a permit to do the work and installation as indicated.
rani t that -- --- ---- _ .
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
improve ents to your property. A Notice of Commencement must be recorded and posted on the jobsite
befor h first i spection. If you int n to �oblinancin' consult with lender or an attorney before
c n or recordin u No 'cefmencement.
re of Owner/ Less ee/Contr&ctor as Agent for wrier I Signature of Contractor/License Holder
STATE OF FLORIDA_.,,.' I STATE OF FLORIDA
COUNTY OFf,(i = COUNTY OF
The forgoing instrument was acknowledged before me
this '10 day of A"pmw� fggR 20V by
13 tau C'd Cf�wC
Name of person making statement.
Personally Known ✓ OR Produced Identification
Type of Identification
Produce
(1'
(Signature of Notary •le*ide�
CATARINA P. SNEED
Commission No. '* ; CommiSSiq@�� ��1 117577
xplM A . , 018
REVIEWS
The forgoing instrument was acknowledged before me
this Iday of 20_ by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced 1
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
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RVISOR I PLANS VEGETATION
'IEW REVIEW REVIEW
DATE -"'' OF ` '` ,.
°' y 0g ffl, �xpi�es May 27 2G19;,
RECEIVED ®®fld@tit rough National otar Assc.f
DATE II
COMPLETED no 0 \ Al
SEATURTLE MANGROVE
REVIEW REVIEW
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