HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ` I • '(11�
Date: (i Permit Nu
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NOV 2, 0, 2018
Building Permit Application
Planning and Development Services G ANNED Permitting Department
Building and Code Regulation Division BY St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982 ,
Phone: (772) 462-1553 Fax: (772) 462-1578 t(I`O - Phod pa Residential
PERMIT APPLICATION FOR: To Select from ropbox, click arrow at the end of line�
PROPOSED IMPROVEMENT LOCATION: Iq p
Address: �% /� .i � I O 2
Legal Description:
Property Tax ID #: %l y " 00 l — QOt
Site Plan Name:�}Ll��, G��S
Project Name: W#10 AINA q
Setbacks Front X Back: �C� Right
Left Side:
Lot No.J
Block No.
DETAILED DESCRIPTION OF WORK:
H®vs r-v CoiVslI v room l �D ��ol I 4',� c/�/� �#X�/=
CONSTRUCTION INFORMATION:
Add itional work to jbe nej orme under this permit —check h a apply:
�IHVAC l-1 Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric ®Plumbing XiSprinklers Generator � Roof Roof pitch
Total Sq. Ft of Construction: 7 S . Ft. of First Floor:
Cost of Construction: Utilities: _ Sewer O Septic Building Height:`
9- r -,� I
OWNERAESSEE: IV
CONTRACTOR:
Name ffilVl7?�l'�lf�1s.6 V/;' 114
Name:
Address:_J��y Tl%, ��� /��� ��� %/
Company: G
City: ,�%'I/n C/ �, Stater
Address d I of
city: - State: L-�
Zip Code: lr1 Fax:
Phone No. %/ �L%, 21?f%
Zip Code: ��1'%�r Fax:
Phone No. 1n%2 - ?41 '99/��
E
E-Mail:IG-�
E-Mail: `%jam A!20it 0 CQ
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
1
State or County License:
It value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
P -E
SUPPLEMENTAL CONSTRUCTION LIEN LAWINFORMATION:
DESIGNER/ENGINEER: Not Applicablel
Name: G'� /alCi{ g
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: Stater
WPu-hone
City: State:
Zip: •-
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
I
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is he4y made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior tolthe issuance of a permit.
St. Lucie County makes no representation that is granting a
which is in conflict with any applicable Home Owners Assoc
structure. Please consult with your Home Owners Associatii
In consideration of the granting of this requested permit, I (
in accordance with the approved plans, the Florida Building
The following building permit applications are exempt from
accessory structures, swimming pools, fences, walls, signs,
WARNING TO OWNER: Your failure to Record a No,
improvements to your property. A Notice of Comi
before the first inspection. If you intend to obtain
commencing work or recording your Notice of Co
Af Owner/ Lessee/Contractor as Agent for
STATE OF FLORIDA
COUNTY OF
The forgoing instrument w s acknowledged before
this aTday of 26 1_1 by
Name Of perso aking statement
Personally Known OR Produced Id(
Type of Identification
Produced
(Signature of Nbt�ry Public- State of Florida )
Commission No. (Seal)
REVIEWS FRONT I ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
rmit will authorize the permit holder to build the subject structure
ion rules, bylaws or and covenants that may restrict or prohibit such
and review your deed for any restrictions which may apply.
hereby agree that I will, in all respects, perform the work
)des and St. Lucie County Amendments.
idergoing a full concurrency review: room additions,
een rooms and accessory uses to another non-residential use
e of Commencement may result in your paying twice for
mcement must be recorded and posted on the jobsite
nancing, consult with lender or an attorney before
mencement.
Contractor/License Holder
C UTNTYOFE OF ORIDsA
The forgoing instrument was acknowledged befc
W this day of X1 U'1%• 20L& by
Name of peison making statement " it
Personally Known ✓ OR Produced Identific
Type of Identification
Produced
(Signature of No&� Public- State of Florida )
Commission No.
(Seal)
SUPERVISOR REVIEW 1 I RE EW I VREVIEWON I S EV EWLE I MANGREVIEWVE