HomeMy WebLinkAboutBUILDING PERMIT APPLICATION•
ALL APPLICABLE INFO (MUST BE COMPUTED FOR APPLICATION TO BE ACCEPTED %
Date: �� 0 �� Permit Number:
RN5tt* = - SCANNED
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Building�Pe°rm t Aoplicatio
RECHVEU
Planning and Development Services MAY 0 8 2018
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Permitting
��Departmant
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial FL
PERMIT APPLICATION FOR: Building I
PROPOSED IMPROVEMENT LOCATION:
Address: 0303 NORTH aLLZ ; P P1C— PEA FL 3+c)5I
Legal Description: Lakewood Park -Unit 8- BLK 94 LOT 21 (Map 13/02N)
Property Tax I D #: 1301-608-0182-000-2
Site Plan Name:
Project Name:
Setbacks Front Back: 15' Right Side: Left Side: 7•7
I
DETAILED DESCRIPTION OF WORK:
Install enclosed 244-M I-tw-detached accessory structure on footers/concrete
**NO ELECTRICITY**NO PLUMBING*'
Lot No. 21
Block No. 94
CONSTRUCTION INFORMATION:
itiona wor o e ne orme under t isl permit —check a apply:
OHVAC LJ Gas Tank El Gas Piping _Shutters ❑ Windows/Doors
Electric El Plumbing Sprinklers E] Generator Roof 3/12 Roof pitch
Total Sq. Ft of Construction: 840 I S . Ft. of First Floor: 840
Cost of Construction: $ 10,046.25 I Utilities: 0 Sewer ✓❑_ Septic Building Height: 14
I
OWNER/LESSEE:
CONTRACTOR:
Name P#rPJC-1,� M
Address: 8 303 N0iQT11 BLVb I
Name: V A M ES PLAYE1q
Company: C,+RP0227_6 4NYW I?ERC
City: FOIeT PIERCE I State: Fl-
Address: %O BOX 77 G
Zip Code: 34'95/ Fax: I
Phone No. ('��:Z. 3i�'" 0% 3 I
E-mail: /'N/%'i/ ���?(:�az. com
Fill in fee simple Title Holder on next page (if different
City: d7 AiiRJ<E State: FL
Zip Code: Fax 5/�� �68 -1113
Phone No. (3 (off—�
E-Mail:
from the Owner listed above) i
State or County License: C8GI25 °19�
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
N a m e: BEC4-trOL EN
_ Not Applicable MORTGAGE COMPANY: _ Not Applicable
12JI44 4AIb TES 146 Name:
Address:W WQST NEW YO Address:
City: aEt.*Nb State:l L City: State:
Zip:31.720 Phone I Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:_
Not Applicable I BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application lis hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced to the issuance of a permit.
St. LucieCounty makes no representation that is gi �.Jrior
ng 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.per�� it, I do hereby agree that I. will, in all respects, perform the work
in accordance with the approved plans, the Florida Bdilding 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 oflCommencement must be recorded and posted on the jobsite
before the first inspection. If you intend to btain financing, consult with lender or an attorney before
commencing work or recording vour Notice lof Commencement.
Signatu f Owner/ Less'ee/Contractor as Agent f 'r Owner
Signature Contractor/License Holder
STATE OF FLORIDA
COUNTY OF B DFQI2A
STATE OF FLORIDA
COUNTY OF h3 _4bFI�,r�A
The forgoing instrument was acknowledged befor� me
The forgoing instrument was acknowledged before me
this day of .Ql: , 2018 by
this 2day of .4PRaL 20 `_S by
�+n�IEs AL9YE
clA-n��s P/-,Iy�
Name of person making statement
Name of perspri making statement
Personally Known )C OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida I
(Signature of N
i
Commission N 1vsY.na Notary Public Sta(6�jorida
., %V, Mana Burgin
osur Notary Public State of Fbljda
Commission No Maria R Burgin (Seal}
My Commission FF 912775
My Commission FF 912775
ova
or n Expires 08/25/2019
�Of Expires 08/25/2 M
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Rev. 8/2/17