HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPETED FOR APPLICATION TO BE ACCEPTED'
C
Date: �, 11 / l �i Permit Number: Z3 0 Y-0 r
SCAN'
v.� r BY RECEIVED..
RECEIVED
Building Permit Application APR 112018
Planning and Development Services Permitting Department
Building and Code Regulation Division St, Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (77.2) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: �� a-�/Ol,l t-v--)
PROPOSED. I'NP�RQV MENT LOCATION 'a
Address: 6 003 6 Am R 0 0 �i y 2 P T P iCAcE FL 3 5"?92
Legal Description: / "0 AN Q.! V'6A f S'T,} T ,� S
1
Property Tax ID#: 2Ly0a — NO— Oy0S',—Oa0— 9 Lot No. 2S—°26
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right'Side: Left Side:
DETAILED.DESCRIPTION' OF WORK
lZ 6 m ova to L ACE '0 ,f C K R Q 04 A'0s
Dzc x Gy ITH R.AF-r4A Xea,s//z/9cE01,E1y7
H R 6 A/ 46 4� Al LC !O
.:CO'NSTRUCTtON INFORMATIC►N
Ad.ditional work to be pertormed under this permit —check all t at a :
Mechanical _Gas Tank _Gas Piping __Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Pod
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ c]Ci�� �`y Utilities: —Sewer _Septic Building Height:
C1VttNERJLESSEE
CONTRACTOR
Name
Name:
Address: 6602 9,1M doy D R
Company:
City: F T J01,612 C d State: L
Address:
City: State:
Zip Code: 341 `182 — Fax:
Phone No. 77 2 y 96 - - J3 9
Zip Code: Fax:
E-Mail:
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.
SUPPLEMENTAL
CONSTRUCTION LIEN LAW IN. ORMATEOW
L a'
.DESIGN ER/ENGI N EEK-, - Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Address': `<<- - `w,-':._`; :`_ '
Address:
City: State:
City:` State:
Zip: "fs- i ;Phone
Zip: Phone:
fEE SIMPxLE,TITLE ;HOLDER: -,�. ? Not Applicable
BONDING COMPANY: Not Applicable
Name: , ,
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 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
is. in Home, bylaws -and
which conflict with any applicable Owners Association rules, or covenant's 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.
i
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 obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
6L
natu�e,Gof,0iune /!L see Contractor as Ag V,1 er
Signature of Contractor/License Holder
STATE OF FLORIDA: -,,;. ?oq = y :
STATE -OF FLORIDA ,
COUNTY OF
COUNTY OF
The forgoing instrument wag acknowledge b car ftSS
The forgoing instrument was acknowledged before me
this � day of F t.� 20 2'm�"
gig
this day of 20_ by
c m x
(Name of person acknowledging)
N
(Name of person acknowledging)
�
a
(Signature of N to yPublic- State of Florida)
(Signature of Notary Public- State of Florida )
Personally Know;/OR Produced ;Identification
Personally Known OR Produced Identification
Type of Identification
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
DATE
RECEIVED
DATE
COMPLETED
iev.7/2014