HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ` • p
Date: Permit Number.: 1S ' of c�.
SCANNED
By
RECEIVE
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit Application APR -4 2018
Permitting Departme
Commercial Resid St. 'u 'e County, Fl
PERMIT APPLICATION FOR:
P QPOSEI3Q`INPRDI%EM NT LQ:CATJQN 8 .a 11 ,' s
Address: 5 20 e, DQ 27- 0 L2L L—
Legal Description: NPlAt-,S 2-1V -&Z LDS l�3 t. OLoCUN f t-g — LbT
•`ZS ,&CZ- iZEG(DE,�TAL
Property Tax ID #: 3� G �D' DG D8-Od0- Lot No. .3
Site Plan Name: Block No. 91
Project Name: 96 J/DE-AIVAI- FE/116c�_ A16-U)
Setbacks Front-0 A Back: 0 -0 Right Side: O,O Left Side: O - b
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Name iC;N Z)A
L'�
Address: ffe0 A Aa,551 1�- / _-4
yCgFnpany
City: -rol't State:
ss:
Zip Code; /V9,U Fax: yS.5 %34 23 6 r
City: State:
Phone No.
Zip Code: Fax:
E-Mail: /"QQ It'Q1
T
Phone No
Fill in fee simple Title Holder on next page ( if different
E-Mail
from the Owner listed above)
State or County License'
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
NT SA ON
`DESI'GNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
-N-6me,:
N am' e:
,,,
Add '.e sn ,x-,". 04 1 1
Address:-
J
-
City. U2 " n:J D %v s J0 j State:
City: State:
Zip: - Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name:
itAddress: ,—, Address:
, VJilOul=
-city: City:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT:'Applicatioln 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.
I
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
is in
which 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 ssociation 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 exemi pt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, wall!4 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
I
improvements to your property. A Notice of Commencement must..be recorded and posted on the jobsite
before the first inspection. If you intend toobtain financihe,'consult With lender or'a waft6rh ey before
commencing work or recording your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for
Owner
Signature of Contractor/License Holder
STATE OF FLORIDA,
STATE OF FLORIDA
COUNTY OF lu-clie
COUNTY OF
The fo4oing instrupent was acknowledged-befoi e
me
The forgoing instruffient'Was ackn6WIedged-before me
this gs� day of 142Vi by
this day of 20_ by
L't 6QA l ey-
(Name of person acknowledging)
(Name of person acknowledging)
(Si re N ta06fiv"tate of Florida)
(Signature of Notary Public- State of Florida
Personally Known OR Produced Identification V"
Personally' Known OR Produced Identification
Type of Identification
L By
�
Type of Identification
Produced TIFFANY
"FRI uced
NOTARY PUBI
JC
Commission Nol rqu STATE OF FL(*Mimission
A
No. (Seal)
con" N"FF9671911
Expires 31212
020
REVIEWS
FRONT
ZONING
SI
PERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW,
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
1�,
b
RECEIVED
DATE
COMPLETED
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Rev. 7/ZU14