HomeMy WebLinkAboutBUILDING PERMIT APPLICATION,7
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:05/02/2018 SCANNED Permit Number:
BY
St Lucie County RECEIVED
Building Permit Applicati n MAY 0 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, pernrift f1$
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
P�ROPQSED INIPROVEM;ENT„LOCATION
Address: I -VA "R, 1A0VW!0 eve W A Lk)Glt 911 55
Legal Description. River Park -Unit 4 Blk 32 Lot-1 3 (Map 34/27N) (OR 3937-2927; 4097-2191
Property Tax ID #. 3419-530-0013-000-7
Site Plan Name:
Project Name:
Setbacks_ Front Back:
Right Side: Left Side:
J�er►oV �� E�{�rir� T1a��l�lal r�o(s (►1�5.
E1HVAC u Gas Tank
RElectric ❑ Plumbing
Total Sq. Ft of Construction: 40FT
Cost of Construction: $ 1675.00
UGas Piping LJ Shutters
Sprinklers Generator
S Ft. of First Floor: _
Utilities: Sewer Septic
Lot No.J3
Block No.
Windows/Doors
Roof Roof pitch
Building Height:
OWNR/LESSEE:
a!
, °a' T
rg t55?L ..
CONTRACTOR,p
r
Name
Name: ON
evi 0SOh
Company: Elite Gas Contractors
Address:
Address: 2130 SW Poma Dr.
City: Port St. Lucie State: FL
Zip Code: 34986-2031 Fax:
City: �a Cf State: FL
Phone No.
Zip Code: 34990 J Fax: 772-220-1829
E-Mail:
Phone No. 772-220-9678
E-Mail: reception@elitegasco.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License: 18361
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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SUPPLE§MENTA* CO�+NSTRUCTION LI€ENi-," N INFORMATIONg
} •.€� §i i' ' ..% .'4f [. i`.'F#' gk rc. . �a� d. ..M1. � �' �� �3' a !�a .. Ys.€.. � +� '� R '" �. 'a
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: Port St. Lucie State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address: 2130 SW Poma Dr.
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
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 obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
C1 111 /
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORI
r���.,
STATE OF FLORIDA
COUNTY OF I)
COUNTY OF
The f rg ing instru nt was acknowledg before me
this day of 201L by
The forgoing instrument was acknowledged before me
this day of 20_ by
Na a of peaking statement
rs m
Name of person making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
41
(Signature of N ary P lifry of EkKi0i0c State of Florida
(Signature of Notary Public- State of Florida )
Lacey L Rizza
Commission No. My CoTgW n GG 168732
OFExpires 12/1 /2021
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
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STATE OF, FLORI
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REVIEWS AONT ZONING SUPERVISQR NAMS TVEG�M , 4 SEA TURtLt' MANdIkOVE