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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ppi�e Permit Number: 19os- ola9 RECEIVED Buildi Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 plication MAR 0 6 2018 Permitting Departm St. Lucle County Commercial Residential i— PERMIT APPLICATION FOR: /i�i�,l�l,lw� 1�oo��G�igr•�P,o�@cs�L PROPOSED IMPROVEMENT LOCATION: • Address: R33 ®%S 04 4111. rr. pliz&C,fi Legal Description: OI.SaA{,S S1,0 , lOAS 7 q Z FF vic I.o! Z-2,, 1,.07r �5'`% a fo Property Tax ID #: / 3 3 "" St7 Z " O o Lot No. Site Plan Name: Block No. Project Name: � e Setbacks Front iC(�G Back: Right Side: �/� Left Side: All � DETAILED DESCRIPTION OF WORK: CONSTRUCTION INFORMATION: ! itiona wor to a Dej orme under this permit - ch'eck EIHVAC LJ Gas Tank Gas Piping all apply: _ Shutters a Windows/Doors 11 Electric 0 Plumbing Sprinklers F� Generator Roof Roof pitch Total Sq. Ft of Construction: 417to S . Ft. of First Floor: d Cost of Construction: $ %/, 00 Utilitii s: _ SewerSeptic El Building Height: OWNER/LESSEE: CONTRACTOR: Name g$SS f e .5' 4%)J0t✓ .4 JXt Address: 23J OL S©At ITV' Name: S-r=die Company: 9 /49H L SOWA4,6 l- �at� JST2/A.S G City: efRR6f, State: fL, Zip Code: J 4 N6 Fax: Phone No. J 7 7 ` 580 E-mail: r-®Na tic-9 ,7Ak4arg' e, 4qL, Goc., Address: 13 79 S-u)- 011- l'`(01Q151 47" City: p s 1 S �J c'cx State: �U' IZip Code: 3� i $ �3 Fax: -772-97?-b ;hone No. Fill in fee simple Title Holder on next page (if different EI Mail: Kq dWIAW a hot - Go w State or County License: C. 11rC tS076"f 4 from the Owner listed above) II If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: F A C r U,1 -fS 4' jg Address: 6 a 7 z A013e7 e%X T104 MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: City: _ P P 'L S State: F 4 Zip: 2 Phone 070E- s 31� I FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: Not Applicable Name: Address: City: Zip: Phone: Address: City: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Applic tion is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has comme ced 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 0 Hers Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owner s 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 a tempt from undergoing a full concurrency review: room additions, accessory structures, swimming pools, fences, �alls, 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 o_r recordin vour Notice ofjCommencement. I Signature of O ner/ Lddsee/contractor as Aeent for Owner Signature of Co ractor/ ense Holder STATE OF FLORIDA �. �e I U �'` STATE OF FLORIDA G COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledgedjefore me this J_ day of MAg " 1 20 by this 1 day of j✓laix` 20_E by Name of person making statement I Y Name of person making statement Personally Known V OR Produced Identification Personally Known �— OR Produced Identification Type of Identificatio Type of Identification UPred_ Produced (Signature of Notary Pub ic- State of r (Signature of Notary Public r Note u Io state of DFIkWddallo No. � Danln9Commission ry Pubfic State of FbridaCommission No.DY IlS FF 181228 Co�nmiselon FF 93 � e� Explros 1012712019 My C'min ssion '"li i.My 0P�0'� Expires 10127/2Ole REVIEWS FRONT ZONING SUPERVISOR PLANS EGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIE REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED 11 tev. 8/2/17