HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
I O
Date: �j ' lc)' IS Permit Number:
SCANNED
- -- VLucieg Application Permit A lication
Planning and Development Services I
RECEIVED
MAY 10 2018
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Resi&at T Eounty, Permitting
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of lin -,06
PROPOSED; IM-PROVEMENT LOCATION':
Address: 13r'
V
Legal Descript(rf. VI s� $N� A -� 1y
LtE
Property Tax ID#:
Site Plan Name: e— r
Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
;DETAILED, DESCRIPTION OF'WORK:
-rvs o I gal l on Gos 1dy1 L -0
qefY-f afor
CO _NSTRUCT_iQK INFORMATLON-:' !
_
itiona wor to e e orme un ert isperm,i , t — ch,cl all
11HVAC Gas Piping
apply:
Shutters Q
Windows/Doors
Gas Tank
FI
Electric Plumbing []Sprinklers
11 I
Generator 0
Roof Roof pitch
DESIGNE
Name:_
Address:_
City:
Zip:
NTALL- O
NGINEER:
Phone
Nl LIEN ,Li41lU' INFORIVIATI'O,Nj•
Not App
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Ad d ress:4252 Bandy Blvd.
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name: Blake Cowdell
Address:
City: FortPierce `f r'
State:
Zip: ,Rh'one'u
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby 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, y,'r
covenants that may restrict or,. prohibit such
structure. Please consult with your••Hbme Owners.Associatio�i ad�r neview your: deed�for apestrictigns 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•pe'rrriit.appl)cations_arr exempt from undergoing afull concurrency review: Iroom 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 vour Notice of Commencement.
LUNA &06k&
Signature -of Owner/ Lessee/Contractor as Agent for Owner
_ STATE OF FLORID,@C!
COUNTY OF 1
Thefir r i instru a was acknowledge efore me
thiM of 6-U 2011, by
— ' 2 1 (3, 1 -f-
Name of per making statement
Personally Known A, OR Produced Identification
Type Ide ti 6-0 1 f , •� / „ n,�.%1
Produced �
re of NotJy Public- State of Florida )
— && 604dw
Signature of Contractor/License Holder
STATE OF FLORIDA�� j ,G
COUNTY OF L
The f i insknowle efore me
this �Lt of2 by
00mvOX.P.-, ( I
Name of NVbn making statement
Personally Known & OR Produced Identification
Type of Id��if'c t'on n
Produceq(fC.V Ro w L _� u W 0
of Notary Public- State of Florida )
n No. (Seal) 6xia3%nission No. (Seal)
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RECEIVED
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COMPLETED
Rev. 8/2/17 . ,, 1 n l M„,