HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLEX ei; FOR APPLICATION TO BE ACCEPTED-
Date:f Permit Number: ' O
-- ����� 'RECEIVED
.,
�._ _v_. __� w w�. Sq li1�dinPermit Application MAR 3 0 2018
�� ST. Lucie County, Permitting
Planning and Development Services - 9
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:
`PROPOSED" 1NPROVEMENT "LOCATION
Address: [?2':�55
Legal Description: 1'i of N ctZq _32fl6f W
Property Tax ID #: ;23 3 Z 3 It) ,00(9 Lot No.
Site Plan Name: (ZeS tQY L40 f W6W,49� Block No.
Project Name:
Setbacks Front Back
Right Side: Left Side:
DETAILED DESCRIPTION'OF WORK
fit'
CONSTRUCTION INFORMATION
a
aiLionai worK to De perrormea unaer finis permit- cnecK a
_Mechanical _ Gas Tank _ Gas Piping
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: 2300. -C�"
appiys
Shutters
_ Generator
Sq. Ft. of First Floor:
Windows/Doors
Roof 'SX7i Pitch
Cost of Construction: $ L D , S-2>0 - °v Utilities: —Sewer —Septic Building Height:
DINNER/LESSEE:
CQNTRA ,R y
Name 6cW, Lz75 4F pk L� ['A;QVA Cc.�
Name: S-� eyGt� C& �-c-�u
Address: I.�soS� �ICc'�c nj3
Company: isl;s'r`.0N(,f1&4 Pe_,0FL&
City: I✓r Esc=duce State: ff
Address: X52 71 d\J1J
Zip Code: 3 r[ q LtS- Fax:
City: T:1- iPcc State: 1%L
Phone No. 77-2-
Zip Code: 3L{Q S"Z- Fax: '17Z qw-ldwS-',
Phone No '7Z2- 0 ((o —86z�`7
E-Mail:
E-Mail_ t_"-xoa&ri AA �rrovu�u. d
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License CGLoSS"S a /L22S4
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
K r
DESIGNER/ENGINEER: _ Not Applicable
Name: �� t rGG i on�tci fir,, c�
Address: i'o(, �c�tA,waam,C �vE
City: C--T, ?y—Tz✓ State: ,=cam
Zip: 3te&,s—o Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is here)
I certify that no work or installation has commenced prior to
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip:' ' Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
made to obtain a permit to do the work and installation as indicated.
e issuance of a permit.
St. Lucie County makes no representation that is granting a pe,'rmit 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, 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 in�p�ection. If you intend to obtain 'financing, consult with len ttorney before
commencin,-wo; rec rdine vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for
STATE OF FLORIDA 1CI�
COUNTY OF
The f rgoing instrument wls acknowledge before me
this day of n111AYn 1,� , 20 by
I
U Pk�
i
(Name of person acknowledging)
Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instr ent w acknowledge before me
this day of 20_1& by
11 Pk I OA41 k_9 Q RY
(Name of person acknowledging )
(Signature of Not ry Pudlic- State of Florida)
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Personally Known OR Produced Identification •
Type of Identification
j
Type of Identification
Produced
Produced
..
Commission No. ..`.�a' °��,��,
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I<A R E N S Ni! E L S E Nj
115637
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My Commission Expires
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1 5637
My Commission Expires
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June 1
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