HomeMy WebLinkAboutBUILDING PERMIT APPLICATION:All APPLICABLE INFO -MUST 6E,COMPl0 F( J BE,ACCEPTED S N me 0 0
i , .� U.
Date:� - Permit umber: f
PGANNED� RECEIVED
MAR 2 0 2018
-Building Perm it-Applicati
TPlanning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 '' Commercial Residential
PERMIT APPLICATION FOR: 1
Address: �� a y �s,j� �. .1 O 61
Legal Description:
Property Tax ID #:t3J % Z QU Q - � cam/ !Lot No.' -�
I
Site Plan Name: IBlock No. -
Project Name:
Setbacks Front • ZC® Back: ZZ,( Right Side: Left Side: �r
-5-1z 7
127WPW_"I W-4 z rQ F M
er tnts permit -
_Mechanical . _ Gas Tank —Gas Piping
,/Electric
umbing _Sprinklers
Total Sq. Ft of Constructions inn. o�
1
Cost of Construction: $ ��(�, 0oo Utilitie
Name I-uh--C- 4 SA2V G01 5P�V-N\ J -
Address: (0?J5_Z- ; I&) MMG"C_`J Zd,L
City: RoRT ST, c) o-t C. State: -EL
Zip Code: 3y �C v�c�n Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
an tnat appiy:
_ Shutters _ZWindows/Doors
Generator Roof
Sq. Ft. of First Floor:
s: ZSewer ZSeptic Building Height: Zz
Name: r[4otii
Company:
Address:
City: 1 ��l t� cC' i State:
Zip Code: 3 9'8 ( Fax: iiZ 40 -03 ZS
Phone No. ) Z- Z 1 C--1 l F, c
E-Mail: JZi4Iy►c-12-1h • Z4 @. Be-1 5-41, , ��E1
State or County Licenser
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY Not Applicable
44,- zl t
City: Pc)T 5%. c<<6- State: ( City: 19
Zip: Phone: ?�"Z- 7d.- _ ��15 7 _ Zip: 3 °t Ir q Phone `766 - 1149 '
1 � ...
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.
l certrfy.that no:work or installation has°commenced priorto the issuarice 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, sign , 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 Col, men cement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtalin financing, consult with lender or an'attorney before
commencing work or recording our Notice of Gommencemen
..t
S' nature of Qw e /)%dent/ Lessee
Signature of Contractor rcense Holder
STATE OF FLORID
COUNTY`OF 3A 1-0Q \e,
STATE OF FLORIDA
COUNTY OF 5� .LiJG1�
The forgoing instr ment was, acknowledged before me
this l(� -day of 20A by
The forgoing in tr ment was acknowledged before me
this ]o day o = V, 20,' by .
(Name of person acknowledging
(Name of person acknowled i
Na� )
(Signature of Notary Public- State of Florida)
(Signature of NotPublic- St to of Flon a )
Personally Known OR Produced 1clentification
Personally,Known�_ OR.Produced Identification -
Type of Identification "'Produced
Type of Identification Produced.
�A;:`::Go BArieRA A, GOMION
Commission No.e10
�o�++.+.;° , BARBRA A. GOODMAN
Commission Noc"� * tt9'MMMISSION#FF101341
*tip&QMMI$$I0N#FF101341
EXPIRES: March 12,
2018
EXPIRES: March 12, 2018
m'9�oF�oa�Oe
BondedThruBudgetNat ryServlcee
BondedThruBudgetNotarySenices
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIE
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 7/2014