HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONf
All APPLICABLE INFO MUST BE LOMPLEi to rOR APPLICATION TO BE ACCE ED
Date: it Permit Number: 16$ 1-0 OqS
SCANNED RECEIVED
' BY
St�IudeCoupt.! MAR 16 2018
Building Permit Appli t�ion ae County, Permitting
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (172) 462-1553 Fax: (772) 462-1578 Commercial .'Residential''
PERMIT APPLICATION FOR:
Address: Z Y�
Legal Description:
Property Tax ID #: 14, d ? - 56
Site Plan Name:
Project Name:
Setbacks Front Back
/Gll� -J e01S C AO' A
s.� C�IU��a.✓
Right Side:
Left Side:
Additional work to be performed under thus permit- cneck all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator // Roof Z �- Pitch
Total Sq. Ft of Construction: •SD Sq. Ft. of First Floor:
Cost of Construction: $ A(, / 0 �, o o I Utilities: —Sewer _Septic Building Height:
� I
0 t(E f i�S IF m R
`,C'0NTCRv 6'
Name G'�'%i!�:d;.�% _ fJor "k�u� �' / I
Name:.c ' a e'_ G' W wA--/e y
Xlddresps` ""'"rN�S" s�Si
Company: Tu-fG,�``" Z31.¢.voL h�vo%'
City:, '�uikte keG U)1: State:-,f�
.. . ,;c i:;;.;-. •' ..
Address: -61 i0•o!r ; /.SS7S�;nu:
Zip Code: ff J!A 't(* Fax:
_'
City:
Phone No. 1// 41 • Jr3 y .. � 75� �
�;: > . �-:: •�, _ -_. _
ZipCode: � � ��'� Fax: •
E-Mail:
Phone No 77.7 37a -7
Fill in fee simple Title Holder on next page (if different
E-Mail ZT-. i 7(Rs1&A14Q &V0Aj,,, b ar)l-eo
from the Owner listed above) I
State or County License e CC- /.J
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
NGINEER: ✓ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name: C.#%Vdy 1lJdskk.r'/
Address: -I" .ye�-tt/e s /ad-
city:
Zip:30 4 s 1 Phone: .,<i4!-,"P- P Vf cl
MORTGAGE COMPANY: Not Applicable
'Name: _
Address:
City: State:_
Zip: Phone:
BONDING COMPANY: ! Not Applicable
Name:_
Address:
City:_
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 authoriz&the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,. bylaws or'andcovenants that may restrict or.pro.hibit such
structure. Please consult with your Home Owners Association -and review your deed for any restrictions which may apply.
In' -consideration. -of -'the granting ofthis requested permit, I do,hereby agree that'l 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 accessary uses to anothernon-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.
e
Signature of O ner/ Lessee/Contractor._as Agent for Owner Signature of Contractor/License Holder V,
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF !S I . "Cl -e COUNTY OF /YI
The forgoing instrument was acknowledged before me, The forgoing instrument s acknowledge efore me
this �— day of'(1'�0_xc_ \ 20A by this � day of uL0 20 Iby
(Name of perso acknowledging) (Nam f person acknowledging)
I
Signature of Notary Public- State of Florida) (Signature of Notary Public -.State of Florida )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identific tion5) l✓ �d9M �.S}Ie�
Produced,= Produced Stateof ftfide
e;•-; CARLA NELSON.
- �,t ires �6/06/2Ct1
Comm'; � - - tateofFlosdal Commission No lo'�
N' o, Commission #.FF 965535 _ .
REVI' SUPERVISOR PLANS VEGETATION SEA TURTLE • MANGROVE
COUNTER REVIEW' - REVIEW REVIEW REVIEW' REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.