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Home My WebLink AboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COM Date: 4:2-5 1 1 PLETED FOR APPLICATION TO BE ACCEPTED SGANNE Permit Number: 1By RECEIVED St Lurie cou* Building Permit Applicati n MAR 2 2 2018 Planning and Development Services ST. LuGIe CaahyOP@i'F 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: To Si lect from dropbox, click arrow at the end of line qs ;, se.=.spe.� � i� � -n P;R®POSE®�MPRUEMENT L®CAiT�.10N �..,.w tR3.t ?� '' q;P ' •` '4:yF `�w�.' is. O �r' ; .< II Address: on: le7 Property Tax ID # � C!a-4—�) Site Plan Name. oon al d Project Name: Setbacks Front Back: _ it67-ANWARMA 112�M Right Side: in Qa�in2 Left Side: 11HVAC IJ Gas Tank E]Gas Piping U Shutters Electric 0 Plumbing Sprinklers E]Generator Total Sq. Ft of Construction: `f� © J S . Ft. of First Floor: Cost of Construction: $ Utilities: Sewer OSeptic a C� -) LD4 Lot No. Block No. QWindows/Doors Roof Roof pitch Building Height: � 011VNER/ESSEE ;` ' CONTRACTOR M ,.*n�N-.w, , 4 _ aFr,. b**%"ssr".t i Name Name: L30 Company: ij Address: 01 rid u a City: f, I State. Address: ity: � .,Icy Zip Code: 1� Fa :��a 1 �� Phone No.`- - Zip Cod Fax: E-Mail: �7 ) %o� --� Phone No.EA E-M�ailL I Ruema, . Fill a simple Title Holder on next page ( if different from the Owner listed above) State-dr County License: If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. I SUPPLEMENTAL CONSTRUCTION LIEN LA INFORMATION' .F DESIGNER/ENGINEER: _ Not Applicable 'i MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: 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. 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 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 requestedpermit, 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 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 our Notice of Commencement. aL (6,4WAta '_ 0 Flak" �Mdug Signature Owner/ Lessee/Contractor as Agent for Owner, ignature of Contractor/License Holder STATE OF FLORIDA +, J_aCI � STATE OF FLORID �� COUNTY OF COUNTY OF Y- The r i n u ent s cn ledg efore me thi a 201 by efore me IV? 20by Th r ru en as �c ledgd1no 161be 'e `� ( IcLi I Name of per making statement //``-- Name of p s making statement Personally Known OR Produced Identification Personally Known OR Produced Identification Type of IdeWc,inn J/ 410 , 1 Produced lJl ��`' l.�/ L-U `'v, Type of Identi • a Produced �NN_ i Igna r f Notary Public- State of Florida) Signa r of Notary Pubp.o • F d� ' \�\\\1111111111////�� Commission No. �� \�R. CQ ��i��SSeal) p/V U '. Commission No. �: ° •`0 cj 30- p�F��Q _� , ?-, - --, PUBLIC REVIEWS a =FRO T®B -din L BNIN'G :SUPERVISOR PLANS VEGETATIOI'`r r/�A'R9R`MANGROVE VU R RE W � REVIEW � REVIEW REVIEW �� Firm r$aA\�\\�`�� REVIEW DATE RECEIVED ��TFOF 10v,��`��\`\ DATE 11111 COMPLETED Rev. 8/2/17