HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMP�Lr i ED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: S-1- 0 C9
SCANNED
BY
RECEIVED
St Lucie Courih/
LRE E
C
t MAY 0 9 2018
Building Permit Applic tion
Planning and Development Services P r itti
Permitting Department
6
Building and Code Regulation Division St L u r
St. Ludie-gounty, FIL
2300 Virginia Avenue, Fort Pierce FL 34982
Residential X
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial P i(i P ntial
PERMIT APPLICATION FOR: Coln C�i&OA e 4t AtA*-,
Address: lu 6—� 3 4
Legal Description: _&it) A%'Ai) uvzr ss+ws Q(\I-� - a 3�- OW 23
Cmqf 2q/JtS�-Cor Lto 6 5 - a- 7
Property Tax ID #: 0 — 600-3 Lot No.
Site Plan Name: Block No.
Project Name: WfJ NO f " Ilk O-SiW-1
Setbacks Front Back: Righ� Side: Left Side:
U*N 0 r—e+e., h Q C f?L+ �,Q h T—e r>-) 0 V
Additionalwom to be pertormecl under trus permit — cnec.Kai.i. tnat'apply:
Mechanical GasTank Gas P ing. Shutters Windows/Doors
Electric Plumbing Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction: Sq,:F - i. of First Floor:
Cost of Construction: $ +.1600 Utilities: Sewer _ S eptic Building Height:
11135600,' ITIROOCATUBM11111111-
Name ARACkV QDRWI�
Name:
AddressA 6 01 W1
Company:
Address:
City: 40r+ e,,trQk State:
ZipCocle: 2WL ' Fax:
-.Phone No. 77�-- �-4
city: State:
Zip Code: — Fax:
Phone 0—
E-Mail: Ard Cq V 10 1 quatiti - A si
Fill in fee simple Title Holder on next page ( if different
from the Owner listed. above)
�N
E-M i
or
ate or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
L W I @ M BNOW I & 0 R It QS IN= T I KNIM 9 810 A. 0 1
DE-SIGNER/ENGINEER:- Not Aoplicab I e
MORTGAGE COMPANY: Not Applicable
.
�5�,V&c 04-L-
Name:
Addr'.ess:
City: oct"Ag%illitiz I State:
State:
Zip: Phone 3,0-�- 221 — IS 13
Zip: Phone:
.,!"�F�E.,51.MP,LE-TITL.E,HOLD-ER:.,,. Not Applicable BONDING COMPANY: Not Applicable
Na,me*. Name:
A_Addr_bs_S`:.' Address:
city: City:
Zip: Phon Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT:'Applicaltion is hereby made to obtain a permit to do the work and installation as indicated.
I certifV that no work or installation has commen�ced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an9covenants 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)' 1-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 onthe jobsite
before the first inspection. If you intend: to obtain financing, consult with lender or an attorney'before
commencing work or recording your Notice of Commencement.
ao�
Signature of Owner/ Lessee/Contractor as Agent for C
ae
Signature of Contractor/License Holder
ro.
STATE OF FLORII)t4�
R��
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The fproing instrum ent was acknowled 4fore m
acknowledg
gs4efore m
i5y
:9 g:g 1�
Ki
The forgoing instrument was acknowledged before me
this dayof n2O,4A I 2p
20LD
se 2
�
this day of 20 by
I _
0
(Name of person acknowledging)
Ko
(Name of person acknowledging
t f I ri I
r, rin
(Signature of Notayl Public- State of Florida
(Signature of Notary Public- State,of Florida
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identifi i
Type of Identification
Produced MA - k - _,&(� -
Produced
Commission No. (Seal)
Commission No.. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
R;4,
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rew. 7/ZU14