HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:' 3 ' j� I Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462
PERMIT APPLICATION FOR:
Address: 7401
Legal Description: —K
Property Tax ID #: f 3 d 1 60
Site Plan Name: -a It w a
Project Name:
Setbacks Front Back: -
"CANNED
BY
unie County RECEIVED
Building Permit Application MAY 0 3 2018
ST, 1. de County, Permitting
L578 Commercial Residential
ON
7 Cc,,.. r-/ C) a .
pa+ nn �rr
h c�
CJ i CJ D Oj 1 Lot No. 7
Block No.
Hoaitionai worK to oe perrormea unaer tni
_Mechanical _ Gas Tank
Electric _ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ / d !nJ
Right Side: Left Side:
►-a
pe Imit - cnecK aii tnat apply:
Gas Piping _ Shutters _ Windows/Doors
_ Sprinklers _ Generator I/Roof Pitch
Sq. Ft. of First Floor: Z/ ' /-?-
4 Utilities: —Sewer _Septic Building Height: .
Name K r - 11 e. r- rat UQ f f-t 0 tNr
Address: 7G'^o f S a.,
City: .r_, u d -r p l-ec [-e- StE
Zip Code: :1 Y4 �Fax:
Phone No. . i 1.J• 3 3 `i G O
E-Mail: rr v F .� 4 "I LE fjc-t
Fill in fee simple Title Holder on next page ( if di
from the Owner listed above)
If value of construction is 2500 or more, a RECORDED
s Name:
- Company:
Address:
City: State:
Zip Code: = fax:
Phone No
rent -`.E-Mail z
State or County License >
of Commencement is required.
i m
�SUPPI-EMEN -AI ;ONSTf UCTtON LIEU I:AUI/ INFORItIIATION
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:. I
Address:
City: State,
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: I City:
Zip: Phone: I Zip: Phone:
I
OWNER/ CONTRACTOR AFFIDVIT: Application islhereby 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 that
covenants 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.
Signature of Owner/ Lessee/Contractor as Agent for' Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ��J(',I I
COUNTY OF
The forgoing instrument was acknowledgldobeforelme
this day of 20by
The forgoing instrument was acknowledged before me
this day of 20_ by
—'�
Name of person making statement. /
Name of person making statement.
Personally Known OR Produced Identification ✓
Personally Known OR Produced Identification
Type of Identific on I
Type of Identification
Produced �, `
Produced
(Signature of Notary Public- State of Florida) _
Si nature of Notary Public- State of Florida )
,.''w:'o"� KAREN S. NIE
Commission No. °`' commission rx FF
SEN
199prn ion No. (Seal)
' _I)
:4 k-
� a, My Commission F
�pires /
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REVIEWS
FRONT
111111•
ZONING
PLANS
VEGETATION
SEATURTLE
MANGROVE
SUPERVISOR
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 8/2/17