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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE C09,,LrTED FOR APPLICA Date: A SCNT` _ BY St Lucie C Planning and Development Services Building Pere Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Comm PERMIT APPLICATION FOR: To Select from d PROPOSED IMPROVEMENT LOCATION: Address: '144 vp Legal Description: C�1A Property Tax ID #: Site Plan Name: Project Name: Setbacks Frodit� L - 5o i 0(d 1 5-- oc,4 1 TO BE ACCEPTED Permit Number: I RECEIVED~ 6t Application I APR, 2 7 2018 ST. L��.°►unt- Residential_ <, click arrow at the end of line S&e. L l iNm ve el Yz Back:_ Right Side: N N Left Side: DETAILED DESCRIPTION OF WORK: CONSTRUCTION INFORMATION: itiona workto nGas orme un er t is 0HVAC Tank ❑ OElectric 1:1 Plumbing ❑ Total Sq. Ft of Construction: _ Cost of Construction.. $ 19 t oo C) � OWNERAESSEE. Name 17�A�./ kJArltLP•z_ Ity. `&, sow State: Zip Code: 3 `t q 5 '7 Fax: 'hone No. 5101 - Co3Z _ 9 "7 E-Mail: ill in fee simple Title Holder on next page (if differ, rom the Owner listed above) value of construction is $2500 or more, a RECORDED �-kN 9-000N apP y= _ Shutters Generator Lot No._ Block N ❑ Windows/Doors ElRoof = Roof pitch S . Ft. of First Floor: USewer Septic Building Height: CONTRACTOR: Name: ` I l� A ©MEL i Company: Address: '615 City: f"oc A- SA- 4 State: Zip Code: 3'L c? 8(v Fax: Phone No. ?? Z- - 21 f 8 - 3 to q j E-Mail: I host o wl,:.}� State or County License: (26C dZ51 i & of Commencement is required. utbIUMERANGINEER: t. Il /� Not Applicable " Name:r►AU3AirN;oIfmu i.tJp C�A.Q 6c.lv1aEL9p� Address. City: Igor+ State: Zip: 3 I c0 Phone ll► - 3 r -54sco FEE SIMPLE TITLE HOLDER: V- Not Applicable Name: Address: City: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby rr I certify that no work or installation has commenced prior to the St. Lucie County makes no representation that is granting a permi structure. Pleaslecconsult with applicable Home OwnOers Associationt and In consideration of the granting of this requested permit, I do her( in accordance with the approved plans, the Florida Building Codes The following building permit applications are exempt from under, accessory structures, swimming pools, fences, walls, signs, screen WARNING TO OWNER: Your failure to Record a Notice of improvements to your property. A Notice of Commenc( before the first inspection. If you intend to obtain finan Commencing work or recording our Notice of CommenI —A I _L/ 1-4 Signature of Owner L Xseeo t Agent for Owner STATE OF FLORIDA COUNTY OF_ *.`,-v- L.,,c; Fr The forgoing instru ent was acknowledged before me this723ra day of 'r: IL 201-9 by Name of pers n making statement Personally Known OR Produced Identification Type of Identification Produced of Notary P1,1616state of Florida ) Commission Oy,RY Pf,BG Notary Public State of Florida ? Liza D Mayfield M Com ission FF 243393 of s<o Expires 0 /31/2o19 REVIEWS PERVISOR COUNTER REVIEW REVIEW DATE RECEIVED DATE COMPLETED W. 8/2/17 MORTGAGE COMPANY: NotApplicableName: Address: City: State: Zip: Phone: BONDING COMPANY: X Not Applicable Name: Address: City: Zip: Phone: e to obtain a permit to do the work and installation as indicated. uance of a permit. i will authorize the permit holder to build the subject structure rules, bylaws or and covenants that may restrict or prohibit such review your deed for any restrictions which may apply. !by agree that I will, in all respects, perform the work and St. Lucie County Amendments. ;oing a full concurrency review: room additions, 'ooms and accessory uses to another non-residential use Commencement may result in your paying twice for ment must be recorded and posted on the jobsite :ing, consult with lender or an attorney before cement. Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OF_ S c ' The for oing instrument was acknowledged before me this Z9 day of _AQr; 20a by K A,, 1 KAM (--1 Name of person making statement Personally Known )C OR Produced Identification Type of Identification Produced (Sign&dre of Notary Publi - ate f Florida ) :ommission U%— _ _ _ _ rr_ r� Y P`Notary e4e Liza D Malyfieldte of Florida REVIEW