HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 .50-Rt6GANNED Permit Number.$ n- G 1 @0
RECEIVED
Building Perm it`Applicatio MAR 3 0 2018
Planning and Development Services ST. Lucie County, Krhiltting
Building and Code Regulation Division
230D Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED,IMPROVEMENT LOCATIO„N
Address: //21 (30F14E14- Wk D&F I-Z)At7 F7- FMr-C F1 31
Legal Description: 0RtiN0,C GAWE PAJLI- L-7-S .1 '01 = 3- IFSS V LY JSrr
Property Tax ID
Site Plan Name:
Project Name: rbJ7-b2FT-
Setbacks Front Back: 10 Right Side: / O Left Side: /
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Lot No. I.2 +:K
Block No.
DETAILED DESCRIPTION OF WORK
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;CONSTRUCTION INFOR ATION v:
Additional work o e e e under this per . - check a apply:
LIHVAC Gas Tank Gas Piping Shutters ❑ Windows/Doors
Electric 0 Plumbing Sprinklers []Generator � Roof Roof pitch
Total Sq. Ft of Construction:
UW
Cost of Construction: $ 2. odn a
S Ft, of First Floor: _
Utilities: Sewer Septic
OWNER .LESSEE CONTRACTOR: -
Name IS/12[S&" A 1-'cT-i T-o-tRFJ-
Address: 1(;tJ n0J—:fL 1
City: FT' T I ek-c state .
ZipCode:1l}418Z Fax:
Phone No. 742- CIS - (a 93'-
E-Mail: FV-r g R(F AA • iAM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Building Height:
Name: 1 iAMN Y Ct L&6X5 o N
Company: A4AA&77fV 6)c4&OANZ
Address: $L S J M/l(Zr#nl w
City: P/i-Jk C rry State: F
Zip Code: -M!1" Fax:
Phone No.- -72 - 190b g %Ols
E-Maila{ige.0 nFLQA ,O..(c p, l
State or County License: O S59
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Name: .
Address;
City: State:
Zip: Phone:
FEE SIMPLE TITLE 96WER: J Not Applicable -
Name: -'
Address:
City:
Zip: Phone:
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. Lude-Counttyy makes no representation that is granting a permitwill authorize the permit holder to build the subject structure
which Is in cosict 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, slgris, 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 trance 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 your Notice of Commencement.
STATE, OF FLORIDA ,�
COUNTY OF�
The forgoing instrument was acknowledge . efore me
thi&��day of f r� n� , 2Q�by
STATE OF FLORIDA
COUNTY OFF
The f oing instr ment was cknowiedge?efore me -
thi:�fday of'�� . .-204 by
Name of p son acknowledging) Name of p on admowledging )
of Notary Public- State
rfrersonally Known
Type of Id e , ifi 1
Commission'o`
REVIEWS
i
DATE -
RECEIVED
OR Produced Identification
JANE'1: CONNER.
Notary'p-Wit - S !Ftorida
Comrrtisslon MG 036070
AV Comer: Expires Dec 10, 2020;
lends through a Iona,
- � - --'= SUPERVISOR
R REVIEW REVIEW
7rsonall
re of Noty Known
Type of identifi -"
Commission N
PLANS
REVIEW
REVIEW
State of Florida)
OR Produced IdentlficWon
friary Public - Aftle lorh
Commission.#!-GG 036070
Conn. Expires Dec 10.20
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