HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COIV '11.5TED FOR APPLICATION TO BE ACCEPTED
Date: k4y Permit Number:
® Si Luds Couniv MAY I �2018 ` - ��, '� penrri�ih
Building Permit Application
Planning and Development Services I ymo nt
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CO,n'ln'lercial Residential (/
PERMIT APPLICATION FOR:
Address: Z OZ S^ IT,�/0/i/)POPE A& U I et",
Legal Description:4O/ OG& GOR,�/
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front Back. Right
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Lot No. //
Block No. A
Left Side: .�
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Aaaitionai worK to ne perrormea unaer tnis permit - cnecK au tnat apply:
_Mechanical _ Gas Tank —Gas Pipling _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinki'ers Generator _ Roof Pitch
Total Sq. Ft of Construction: //, OD f Q Sq. Ft. of. First Floor:
Cost of Construction: $ , 0 Utilities: _ Sewer _Septic Building Height:
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�aNTR�cTo�R:
Name md-%-Af am-, e S
I
Name
Company:
Address: ZO Z f �s /'L /i x/ 9�� w� '�
City: /" /01"I C/t Fe-
Zip Code:. V f s-z Fax:
Phone No. 7Y2 ` 3 P f ` 2-L
Stater
i
Address:
City: State:
Zip Code: Fax:
Phone No
E-Mail
E-Mail:C*Pr, 7"04 /991S" V11"A I CD� II
Fill in fee simple Title Holder on next page
from the Owner listed above)
( if different,
1
State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
1
SUP RE:- Wr E T C{ S
RUST ClN I I
INFtRMATtO►N;
DESIGNER/ENGINEER:
Name:
Address:
_ Not Applicable
-
MORTGAGE COMPANY: _ Not Applicable
Name:: ..
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
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 covenant's 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;] do hereby agreethat I -Will, Wall 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
commencine work or recordine'vour Notice of Commencement.
r., �-- �- � C,?!: �?, C�� -
Si ature of Own er/-Lessee/Contractor,as Agent for Owner • Signature of Contractor/License Holder
STATE '.OF FLORIDA
COUNTY OF
The fo oing instrument was acknowledged before me
this j day of 20il by
Ld ui r� bcuo?-s
Name of person making statement. /
Personally Known OR Produced Identification
Type of Identification
Produced �i�, 1',`=' I//rD ,/
STATE OF-FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this day of . 20_ by
person making statement.
entification
OR Produced Identification
Si ature bt NoTa Public- State of Florid Q B"c;`.
(� rY (Signature of Notary Public- State of Florida )
Commission No.� Commission No. Seal
REVIEWS
FRONT
-ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
-.MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
..REVIEW
,REVIEW
DATE
513006,
RECEIVED
.
DATE
COMPLETED
Kev. a/ L/ 1 /