HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I Permit Number:
soq
4' sly RECEIVED
-Bui LUPPermit Application
Planning and Development Services APR 0 3 2018
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ST. Lucie County, Permitting
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 IMPIROVEMENT LOCATION
Address: I `�j�i� NLo T3LLfon bu_ {sn C1ro`e
Legal Description: -I--iC tr VJQJI-JLf
or as gq- l ooa
Property Tax ID #: 442-0— 21 E-5 `
Site Plan Name:
Project Name: Grel!�n I/^G
Setbacks Front Back: _
0
Right Side:
Left Side:
Lot No._
Block No.
TZ
I'DETAILE'D D'E'SCRIPTION,OF WORK
GuHr,r Jl vj •}— i L_�3 1 2-D 0 ,A -t--A 10 1 C�
,Q0+r0-r1,e rQ� ied -pro l�s41P-r LI i LOad- sv1a� ► �g
CQNSTRUCTION INFORMATION':
W
itiona wor to , e er orme under this permit —check all apply:
1JHVAC Gas Tank Gas Piping _ Shutters Windows/Doors
Electric El Plumbing Sprinklers 11 Generator E]Roof Roof pitch
Total Sq. Ft of Construction: /�,
Cost of Construction: $ t Q"y�z I - e2
S Ft. of First Floor: _
Utilities: Sewer 0Septic
Building Height:
OWNER/.LESSfE:
-_
;CONTRACTOR:
Name (-.,
AddressJ'G V
)r
Name: M. I
60(m Zt )
Company
ic.
City: CL I M til State:
Zip Code: 4 "t—1 `b u
Phone N(. -n� � —
Address: -4 a
V
City: l��
Zip Code: c�
Phone No. �
f�
L
tatel1r //,,,,
Fa><: _172 AI ` +
—A
E-M it 1
Fill in fee simple Title Holder on n t page (if di e
from the Owner listed above)
E-Mail:
I
) I
State or County License:
fE13
I — . 9VY
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. I
'UPPLEIVIENTAL CONSTRUCTION LIEN LAW INFORMATION
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:.
City: State:
Zip: Phone:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I
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 thle 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 aid 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 unc
accessory structures, swimming pools, fences, walls, signs, scre(
WARNING TO OWNER: Your failure to Record a Notice
improvements to your property. A Notice of Commei
before the first inspection. If yoyy,Antend t btain fin
commencing work or recordirdrvour No66e of Comrr
�rgoing a full concurrency review: room additions,
n rooms and accessory uses to another non-residential use
:)f Commencement may result in your paying twice for
cement must be recorded and posted on the jobsite
ncing, consult with lender or an attorney before
2ncement. '.0 -001*1
Signature of Ow er/ Les /Con actor as Agent for Owner
ature of Eontr for/Li se Holder
STATE OF FLORID
OF FLORIDA
COUNTY OF 0Jg;1STATE
COUNTY OF
The forgoing instrument was acknowledge before me
this day of , 20_ by
The forgoing instrument was acknowledged before me
this day of , 20_ by
Name of person making statement
Personally Known OR Produced Identification
Type of Identification
Name of person making statement
Personally Known OR Produced Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISO
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17