HomeMy WebLinkAboutBUILDING PERMIT APPLICATION... .... ..... ....
ALL APPLICABLE'INFO MUST BE C 'APLETED FOR APPLICATION TO BE ACC; " D
Dater n ........::..: := ::.Permit Number::.:.:: 0� `. Wen
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B�/ kECENEP : .
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:................ BuiltP r� ..Pi ift App..lication :...........:.:: ::Mav, 02, 2018
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Planning and DeyelopmentServices:.. Permitting oeparEment
... Building and Code Regulation'Division . • • • st. Lucie county,....
:2300.Virginia Avenue,.Fort:Pierce FL 34982 :.
Phdr!6: (772)462=1553 Fax: (772) 46245i8 ... Commercial Residential:::
PERM IT APPLICATION FOR: P ........... . ... .
.J.'
To Select from dro box;.:click arrow:at •the:end 'of line
Address: �1
Legal•Description:
Property Tax ID #:
Site Plan :Name:::
Project -Name:
Setbacks • Front
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Haaitionai.worK,.to'De ertormea..unaer-mis permit.-.criecK all apply:...
OHVAC..::;: GasTank :: Gas Piping 4 Shutters Windows/Doors::
El
s Tank::: err id
:Electric D:Flumbing OSprinklers Generator: Roof
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Total Sq.:'Ft of Construction:: l a Sq.
Ft1. of First Floor:
Cost of'Construction;: $ Utilities: Sewer _ Septic:: Building Height:..
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Name�� .� :•..�•
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.Name:ITomSaurey _ ..� :
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Address: ::: q :: � �:: �::
.... uff Shed, Iha.• .......::.::...
Company: ' T:..
........ .
City:. PYC►� SSlate::
� :8524:E Colonial Dr..::
Address:
Zi Code•
.p: . �. :. Fax: :; :.
:.City:: Orla ndo .:
:. L
State: F
Phone No. ::
Zip Code •32817 Fax`.: (360) 998-3228
E-Mail: ... ..,.. :.. .. : .
hone:No': -(407).9853990::.. :: • ......
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Fill in, fee simple Title:Holder on next page (i �. ifferent
::[- Mji3iI: tuffshed@pertriit=it.com
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from the Owribe listed above): • : :.
State or County License: CB 3645
:IT value or construction.is $Z5ov or more,:a RECORDED Notice of Commencement is required::
11::. .... .... ..... ....... I.... ... -.... ... ....11
DESIGUER/ENGINEER.- . " — Not Applicable :MORTGAGE COMPANY: X N.ot Applicable
Name:Richard Wills #76835:
.... ..::.. ..., ...::• �� Name:......::.. .. .... .
1777 S Harrison Street `Suite 600 : ::
Address: Address:
City:: Denver ; :::. ......::State: j co ... .. Clty - :-........ : Stater
Zip:: e0210 Phone: (303)753-8833; j Zlp :Phone:
PEE SIMPLE -TITLE HOLDER:.::- Not Applicable:'::. BONDING COMPANY: :.: X Not Appl;icabl:e:: .
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Name:
Address: :Address:
I
City: I City:
Zip:. ...::.:: :::...Phone:::.:: j :... Zip: P.ho.ne:.:..'.. .... ... .
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certify that,no work or installation has commenced'prior to the issuance of a: permit.
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St'. Lucie: Count�y make' 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 Assodatlon:rules; bylaws or and covenants that may restrict or:prohibit such.: :.
= structure. Please corisult With your.Home. Owners A"ssociation.and review your. deed for any restrictions which may apply.....
In consideration of the granting:of:this requested permit, .I:1ido:hereby agree -that 1 will, in all respects; pefform the work:: :.
in -accordance with the approved plans; the Florida:Buildiiig Codes and 5 -Lucie CoUnty Amendments:'
:Thefollowin g building per m'it:applications are;exemptfrom undergc?. g.:full concur rency.reyiew: 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 xesult in your paying.twice for:
improvements to your:p.roperty. A Notice.of CornMencement.must be recorded and posted on the jobsite
before the.fir ectlo If. you _infend tobbtain'financing c s It with lender or.an.attorney before..... .
comma yror:k or taco .din : our Notice of Commence
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Ignat4re of Owner/ Lessee/i gent ur
� .. Signat e_of Contract /Lic e: Holder.
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STATE OF FLO IPA. STATE. OF COLORADO
COUNTY.OF.�. . ...... I.... COUNTY OF AENVER . ..........
The forgoing instrument was acknowledgefore me Theo oing instrument was. acknowledged bef..ore me•
day of 20 .Tby :: this • y of March .. . 20 18. b'
j ...
::.. Tom Saure
. ariie: of person acknowledging) :: I (Name of person ac edging )
na f otary:Public-State of Florida )..: I Sign , e of Nota : Publi - State of Colorado)
Personally Known: OR Produced Identification :. I:: Who is personallyknown to me.and did:nottake an oath.:_ "
Type of Identificati n Produe? .... SIXET
Cora
:. ::..... ... .
JL
C Corrimission,No..2002401781.9 ........ (Seal) Commission. No,. "TY-1
''FcaFtoP��c.. aQndeanruBudDeres No ryexvkes.: �:. ST2022
EPH�4NIE=BUTLI=R
PUBLIG
Revised,07/1.5/2014� NOTARY D 2 02EF �0178 9
:. .: MY COMMISSION EXPIRES OCTOBER 1
REVIEWS FRONT::.: ZONING: SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE:
COUNTER::. ..REVIEW : REVIEW ... REVIEW • • ,. ,. ,REVIEW REVIEW R.EVIEW..
. .. .
DATE
COMPLETE
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