HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLE'
Date:
r
FOR APPLICATION TO BE ACCEPTED
Permit Number:
i
�� � I RECEIVED
Odil'i g0160-hit Application APR 0 6 2018
Planning and Development Services L
, Luele Cou
n. Permitting Building and Code Regulation Division ___, g
2300 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
PROPOS. D I�'PROVEMET L®CA 10
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Address: if�00�'j' lrdrece c. P,'e(« 3(4q&:%L
Legal Description: JA' l an iQi W 6+44eS 11 -�-.4 Dy- 6LK 34 40T I 414AN102-4) 6 R 39.0-ZZZS�
Property Tax ID #: 31402- [005 0072.- 0'00- S Lot No. 7
Site Plan Name: cc Block No. �O
Project Name: k.ufnonW ce (ig k—
Setbacks Front Back: Right Side: Left Sider
Hem4ii r%9 S,i 54e "
OHVAC LJ Gas Tank ❑Gas Piping) IJ Shutters
Electric PI,lumbingSprinklers 0 Generator
Total Sq. Ft of Construction: I Sq. Ft. of First Floor:
o�
Cost of Construction: $ �� $ 50 .cF Utilities: _ Sewer E]Septic
Windows/Doors
Roof Roof pitch
Building Height:
W I�'ER%E�SS°EE. 3. ,„ ,yaU -, u
CONI'R+ACCi'ORf '0,�
Name1��Monc%
Name: �� ,<�- ZG 1 ac-r
Company: Sv G< En2144 S45�G�r5
Address: L-1100� Pirle-i-rf_e„ 'Df.
City: fk. e;,e rC _ State: V:t,Address:
(l00 Srh ojl wQ
Zip Code: 34q$a Fax:
City: P;,elc.0 State: ��-
Phone No.% 702• 370 - 99�
Zip Code: 3LJf% a Fax: —n;Z— LIlola•-7937
E-Mail:
Phone No. -1-la- L{loL(' 2-10(03
Fill in fee simple Title Holder on next page ( if different
E-Mail: 31 S0\a4-e ner!2 @yam, h cc;,. Corn
State or County License: CUC O S(vlo3�
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SAL
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DESIGNER/ENGINEER:
Name:
_ Not',Applicable
i
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
!
Address:
City:
Zip: Phone:
State:
City: State:
Zip: Phone I
(Applicable
FEE SIMPLE TITLE HOLDER:
Name:
_ Not
BONDING COMPANY:
Name:
Address:
City:
Not Applicable
Address:
City:
Zip: Phone:
I
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. 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 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 inspection. If you intend to''lobtain financing, consult with lender or an attorney before
commencing work or recording vour Notice of Commencement.
iC`P,�v
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Signature of Contra ctorlt4Qaise Holder
Signature of Owner/ Lessee tractor as Agent fill Owner
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTY OF Luu2
The forgoing instrument was acknowledged beforeme
this Irt day of IN26 ( 120 18 by
The forgoing instrument was acknowledged before me
this b'�^ day ofPt p(-'% k 201$ by
Z ra N acys
Name of person making statement
Personally Known OR Produced Identification
Name of person making statement
Personally Known ✓ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
i � to re� � Ir`�
c( g y ub State$F*a) MarieSarahMusic
C �TARY PUBLIC
�9f4,mission No. F_FgIZ/37� ATE OF FLORIDe
37 Coroi FF912137
019 ExDires 8/24 2019
_ Marie Sarah Mu
'Anature of Notary Public State of Flor
NOTARY PUB
Commission No. FFg/ 7 /,37 STATE OF FL
Comm#FF912
E1� Expires=4/
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Rev. 8/2/17