HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3,l 1rA . 1. Permit Number:
BY
...*!! BuildingPermit A IicatiFnMAR 2 2018
ppPlanning and Development Services nty, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 i
Phone: (772) 462-1553 Fax: (772) 462-1578 1 Commercial Residential 1Z
PERMIT APPLICATION FOR: 0
Address
Legal Description:
Property Tax ID #: o6oL6 Lot No.
Site Plan Name. • AMAd S545 AMC Block No. 3.
Project Name:
i
Setbacks Front Back: Right Side: Left Side:
_Mechanical _Gas Tank _;Gas Piping
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: ZOO
Cost of Construction: $ / Soo• Utiliti
Namelt'E"0 ,$E1&1eA0E5
Address: /2'0/ UJ0oDUJhR1) Die
City: Ire.. POzsjecc St;ate:fG
Zip Code: 3*9v6 Fax:
Phone No. 772— *25—
E-Mail: be19Y-a V es /C @ arihai/. -OI'►�
Fill in fee simple Title Holder on next page. ( if different
from the Owner listed above)
_Shutters _Windows/Doors
_ Generator _ Roof Pitch
Sq. Ft. of First Floor: _
es: _ Sewer _ Septic Building Height:
Name: -
Company:
Address:
City: State:
Zip Code: Fax:
Phone No
E-Mail
State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
•
I
4U00LEItENTA C£?IUSTRUCTlO►NI� SLAW lNFtJRMATt�N��
w
.�
DESIGNER/ENGINEER: _ Not Appli6, able
MORTGAGE COMPANY: Not A
Applicable
Name:
Name.
Address: I G
A4clr.ess4,
City: u.; Sttd:�1,C�ty:,x
r' State:
Zip: Phone .—'"'° `�.•.„. `'
I
Zip: Phone:
FEE SIMPLE TITLE HOLDER: — Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: I Address:
City: I City:
Zip: Phone: I Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to,obta.in 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
is in rules„bylaws andd
which conflict with any-applicable:Hom.d Owners Association oe coven',ants•tHat (pay`rbstrict or prghibit such
structure. Please consult with yo0r 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 follow.,(ng building permit applications are exemptlfrom undergoing_a full concurrency review:;room additions,
accessorystructures, swimming pools, fences, walls, signs', screeQ rooms-and'accessbryuses•to another no-ntresidential use
WARNING TO OWNER: Your failure to Record (a Notice of Commencement may result in yourrpay7ng 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 work or recording our Notice of Commencement.
Signature nertLessee%Contractor as Agent fo
Owner.
`Signaturp'cf Contractor/.License Holder .
STATE OF FLORIDA ' ` ti p
_STATE OF, FLORIDA ..
COUNTY OF Sk.' L� �e
COUNTY OF
The forgoing instrument was acknowledge before
V\9q
Ime
The forgoing instrument was acknowledged before me
this.al day of { 20 161 by
this day of 20_ by
(Name of person acknowledging)
(Name of person acknowledging)
(Signature of Notary blic- State of Florida)
(Signature of Notary Public�State of Florida )
Personally Known OR Pro n1w
01M
Personally Known OR Produced Identification
Type of Identificatio ,.�,,,,,
` DEANNAMARIEGIVENS
Type of Identification
yp
Produced 1. �1' ��°' ISSION#GG022023
Produced'
.t EXPIRES: December i6.2020
Commission No. F '� 1p ondedThru(I FublIc
ndoWtere
Commission No.
a.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION_
SEA TURTLE �..
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
.
REVIEW~ 1
REVfEW
REVIEW
DATE
RECEIVED
DATE .
COMPLETED
ev. 7/2014