HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
ALL APPLIC ,ftBLk INFO MUST BE COMPLETED "FOR APPLICATION TO BE ACCEPTED
Date: O Permit Number:
MANNED
BY RECEIVED
- ------ St Lurie C urnt� .
Building Permit Apprication MAY 10 2018
Planning and Development Services
Building and Code Regulation Division ; ST. Lucie Craunty, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 } Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of lin �5 P
1
,PROPOSED' IM.PRO.VEMENT LOCATION:;
Address: 3 ud Ed 11i
Legal Description:
Property Tax ID #: P,"2—q-131 CXD�P" E)DC)` S Lot No.
Site Plan Name: _Deer Block No.
Project Name: L J, -L -r
Setbacks Front Back: Right Side: Left Side:
;:DETAI:L'ED DESt- RI'PTI'ONIOF VI/OAK:'
1l Z�Ancd
11on -Tan�2rafi(�� C Q noeL-i-
'CONSTRIJGTION, INPORMA_ TION" �..
itiona wor to e e orme under this permit —check, a apply:
CIHVAC vi Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors
Electric D Plumbing Sprinklers Generator Roof Roof pitch
I
Total Sq. Ft of Construction:: S Ft. of First Floor:
/� Utilities: Sewer Septic Building Height:
Cost of Construction: $ U
O.INNER-f LESSEE:,
CONTRACTOR:
Name
Address: 31 31 ld 6
Name: Blake Cowdell
Company: Energized Gas
City: ()Ifyfff CP— Stated: �
Zip Code: Fax:-ftaz3 Jg _U IlTI-U'
Phone N . - P --1 D9 b
Address: 4252 Bandy Blvd.
City: Fort Pierce State: FL
Zip Code: 34981 Fax: 772-318-6672
Phone No. 772-466-1095
E-Mail: � & Ql
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail': ]ennifer.energized@gmail.com
State or County License:
I If value of construction is $2500 or more, a RECORDED Notice of Commencement is,requirea'.
f
:SU.PP.IEM-ENTAL-CON:STRU'CTf �.N,.LIEN' LAIN:INFORIVIATI �,N: .
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not -Applicable
Name:
N am e: Blake Cowdell
Address:
Address:
City: State:
City: Fort Pierce State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Add ress: 4252 Bandy Blvd. Address:
City: City:
Zip: Phone: 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 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 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.
WtGL�(X.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of 20_ by
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 Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State;of Florida }
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17