HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONA!i APAICAB E INFO MUST IWCOMPLE� p OR APPLICATION -TO BE ACCEPTED \ -
Date: a _ :. ` ' . Permit Number: 1$ d 5 ' 0411 ,
SCANNED
By
St Lucie County
.: RECEIVED
_ .. _ .. -- -... -
Building Permit Applica ion- :` `�
--
hAY 0 2 ioi8
Planning and Development Services = ="; _
Building and Code Reg'"ulbtion Division Permitting .
_ST. Lucie 6A�1f5tYr
-2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)-462-1553 -Fax:-(772), 462-1578 Commercial Residential -_ "
_ _ .
PERM IT -APPLICATION .FOR:
Address: 9 K ,&S j M, F
Legal Description:
Property Tax ID #: �'.3'y a•: (7' — d 4.()00 -: :: = ' Lot'No
Site Plan Name: _ i Block Nor
Project Name:
Setbacks `Front ' Back: L._.. Right Side:' LefgSide:
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ev-
izionaI Work to' be performecl
un
ert is permit—c ec
a %t:-at5a.pp y:
_Mechanical _
Gas Tank
_ Gas Piping
�' "r -_" Shutters -
_Windows/Doors
Electeic
- ,
Plumbing
Sprinklers
` c' Generator
;. .._ .
Roof
Total Sq `Ft of construction:
1
Sq. Ft.: of First Floor:
Cost of Construction: $" 'a
100
I Utilities:,, -_Sewer _Septic
Building Height:'
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from the Owner listed ..,
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It value of construction is Z500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: 'Not A - pplicable.,-_
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone:
-zip: Phone:_.; e
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY:Not Applicable
Name: Name:
Address:
!Address:
,
City: I City:
Zip: Phone: iZ!p:- - Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do thq-wqrk-and installation as indicated.
I certify that now'ork or installation has commenced prior to theissuance of a- permit: :
St. Lucie County -makes no representation that is granting a permit:lwili -authorize' the per - mit,'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 mayapply.
, .I
In consideration of the -granting of -this requested permit, I do here' by agreethat'l will, -in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following b i uIlding permit applications are exempt from undergoing a full concurrency review': room additions,,-,
accessory-strUcture's,'swimming pools, fences, walls; -signs; screen�.rooms_and accessory Uses to-ah6th6r'nori-r6sidentiaI use
WARNING TO OWNER: -Your -failure to -Record a -Notice d I f Commencement may result in your paying tiA'dce'f6i
improvements to your property. A Notice of Commencement must be recorded and posted on theJobs'ite
before -the first inspection-: If you intend to obtain finaftirig, consult lenider"6"ir an attJ'orne'y'b6f6re
commencing work or recording your'Nbticb�of Commencement.
P�'AAA_4,
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-Signature of Owner/ Agek Lessee Signature of Contractor/eicense Holder
-STATE OF FLORIDA STATE OF FLORIDA
0. - -
COUNTY OF �d Luu�r COUNTY OF'
The for ping instrqmqt was acknowledge q before me i The:forgqing instru nt was acknowledged- before
this T"'day df-` 10 41.
OL tby� this a I 6LW 20 - by) i_`
�qdayof- Al
�_.. - - nk?,76 4'
ng
Eric_ 'Ulourmle�411
(Name of person acknowledging) uxc)z
9.
(Signature of Notary Public.(,State of Florida),
Personally'Known- OR Produced IdERitificati
Type of Identificatio n�'Produce'd
(Name. of person acknowledging
/ f I . - I / // I i, 4 -, , " ! , e� ., ': ;
(Signature of Notary Pubic- State of Florida)
Personally Known= ORProducedIderitificia-ti I oi
Type of Identification Produced
Commission No.SIoG (Sea[)- CommissionNo.- 7
REVIEWS .-FRONT ZONING' SUPERVISOR: PLANS. ..VEGETATION- .-,SEA TURTLE-_ MANGROVE`-
COUNTER REVIEWREVIEW, .,..REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
colvintTED
Rev.-7/2014
10
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