HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMP kFED FOR APPLICATION TO BE ACCEPTED j
Date: Cp J Permit Number: / N7
SGANNEu _
RECEIVED'
_ Building Permit Applica ion APR =5 2018
Planning and Development Services Permitting
Building and Code Regulation Division g Department'
2300 Virginia Avenue, Fort Pierce FL 34982 St.. U C I U n ty, FL
Phone:.(772) 462-1553 Fax: (772) 462-1578 Commercial Re
PERMIT APPLICATION FOR:
Legal Description:
Site Plan Name:
Project ,Name:
Setbacks Front Back:
amonai worK I
_Mechanical
Electric
Right Side:
I
>RK:
Left Side:
Tormed under this permit — cnecK all tnat.appry: .
_ Gas Tank I Gas Piping _`,Shutters
Plumbing Sprinklers Generator
n: ,2;� 500- 00 Sq. Ft. of First Floor:_
Cost of Constructi n: $ -9000. I Utilities: _Sewer _Septic
Lot No.
Block No.
Windows/Doors
Roof 119MMMOM
Building Height:
0 aR/111 11MS
No 0W'
V fl .nAS
Name:
rBOA
S 7 &KOVF-96 {R�t7 I
T t"i £R('E i State: fL—
Company:
Address:
Zip Code: S425 1 Fax: I
City: State:
532=Sa62-
Zip Code: Fax:
Phone No
Fill in fee simple Title Holder on next page (iif different
E-Mail
State or County License
from the Owner listed above)
I
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
I
SUPP'
EMENTA(. Cf� STR+
C�
If�N EN
-Q'RM IQ'N:
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: —
_ .. _.
Address,,"Y _= ''
'Address:
State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ ,
Not Applicable
BONDING COMPANY: Not Applicable
Name: i I s
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 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 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 Recor4a 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 your Notice of Commencement.
Signature of Own r/ essee ontractor as Agent
Signature of Contractor/License Holder L
STATE OF FL O
o
STATE OF FLORIDA
COUNTY OF
a X
COUNTY OF
The forgoing instrurpqnt was acknowledged befor
a m
409i
The forgoing instrument was acknowledged before me f
this -(p._ day of 20" oy
T so g
this day of _ 20_ by
�
4V
=° N
(Name of person acknowledging)A
(Name of person acknowledging)
t
x
(Signature of Nckary Public- State of Florida
(Signature of Notary Public- State of Florida )_
.f
Personally own OR Produced Identification
Personally Known OR Produced Identification
Type of Identificatio
dr -ti_X C_-.
Type of Identification
Produced
Produced
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW f
DATE
RECEIVED
DATE
j
COMPLETED
Rev. 7/2014