HomeMy WebLinkAboutBUILDING PERMIT APPLICATION.. APPLICABLE INFO MUST BE COMPI's- A_. D FOR APPLICATION TO BE ACCEPTED
Date:' !t - S Permit Number:
SCANNED) RECEIVED
_ BUN19109"09Afit Application MAR 2 3 2018
Planning and Development Services pp
ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-2578 Commercial Residential
PERM IT APPLICATION FOR: To Select from dropbox, click arrow at the end of jine G &S ,
PROPOSED tM't?ROUEMEtVTtiL�OrCATION `� � ` F t ,
Address: 0
a1 `F,. L.,/l C.. O
Legal Description: Rv 8 (, - 34 - I.-r3I
Property Tax ID #: u 425 - 77 o3 - oo41 • oao -
Site Plan Name: Q, A,4 3: c.LA K
Project Name: 991 A%s4 j C LAR
Setbacks Front / 0 Back: 110 Right Side: / O Left Side 1.0
Q �000PA I
' - ray. , �riN cep r P, f,„VA .
_ HVAC V Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers —Gene rator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 23?9T1;1" Utilities: _ Sewer _ Septic
W-4
City: Y kLlk C;mil StYte: rL-
Zip Code: SgI1 O Fax:
Phone No.
E-Mai1: im I A, N X tLyeK,%e-
(�1i'4At L. Copt
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
,Name:
Company:
Lot No. 3 !_
Block No.
_ Windows/Doors
_ Roof Roof pitch
Building Height:
State: I"L
Zip Code: 3411C] Fax:
Phone No. C7 /O IS'
E-Mail: 2R
State or County License: 11 S$,74
City:
ff value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Name:
Address:
City State:
Zip:- Phone:
FEE SIMPLE TITLE 146LDER: _ Not Applicable -
Name: T'
Address:
City:
Zip: Phone:
Name:
Address:
City:_ State:
Zip: Phone:
BONDING COMPANY: _NotAppllcable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: App9icatiori is hereby made to obtain a permit to do the work and installationras indicated,
1.certify that no work or. lnstallation.has commenced 1pri6r to the issuance of a permit
St. Lucie County makes no representation that is gra Ming a permit will authorize fine permit holder to build the.subject structure
which is in conflict with any applicable Home 0wners�Association rules, bylaws or and covenants that may restrict or.:prohibit such
structure. Please consult with your Home Owners Associatio,n 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: toom 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 orrthe 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.
STATE OF VACCOUNTY O LORIDA . ( ( I STATE OF FL
COUNTY OF ORIDA'
The f r oing instrument w cknowiedged fore me
this day of XCU 120�by
(Na-me of person' acknowledging)
(Signature df Notary Pu c-State of Florida }
Personally Known OR Produced Identification
Type of Identification Produced - -
Commission No.
BRITTANY RiEDDIN
st(fleai) Florida -Notary Put
Commission # GG 19028
My Commissionl Exoire;
The forgoing instr e t was cknowledged l;efore me
this-3day of 20 by.
UG60
(Name of person acknow edging )
(Signature of Notary/ Public-.Siate of Florida)
Personally Known OR Produced Identification
Tvoe of Identification Produ
No.
,••++YPRR•, BRITTANY REDDIN
,N'A 10t
SfSeaj} Florida -Notary Pub
_+ •= Commission tt GG 19028
9 My Commission Expires
REVIEWS FRONT ZONING SUPERVISO LANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW . REVIEW REVIEW REVIEW
DATE -
RECEIVED :'