HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE Li7rvrPLETED FOR APPLICATION TO BE ACCEI' ";
Permit Number: NOS ^ Cj, -` q
Date:
SCANNED
BY
L St -Ucle c®uE c V RECEIVED
1.
Building Permit Application MAY z 7'2018
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lui:le Co my
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: I
PROP®SED LNPR®vEMENT LOCATI
lid red ss ��r 9 .p`� AW - «�'-eG.C-�v7
Legal Description:WZ,�) (ld.�ilG,a- -Az /' 44 d� 1� /';/-z&'z e-4:r
C I
q;PropertyTax= 4SU2 •i O/- //5"�000 -d� Lot No.
Site Plan Name: I Block No.
Project Name: I
Setbacks Front Back: I Right Side: Left Side:
I
DETAHLED DESC•R�IPTION � F W®RK:
rem .,Pia�f,�c,C"s.:•n e�� .�r� /�.�"� o?�o ��. ��:��L�I ,emu_ i J'2e�,�,G
C®NSTRIJC 110 1 -OR' M�ATI®
i-10- -Iworktobepertormeci under this permit -check all that apply:
Gas Tank Gas Piping _ Shutters _ Windows/Doors
_Mechanical _ _
Electric _ Plumbing _ Sprinklers _ Generator _ZRoof Pitch
�1ij 01tal Sq. Ft of Construction: /90� 1) Sq. Ft. of First Floor:
Cost of Construction: $ Qi a0.6 . C9,10 Utilities: Building Height:
—Sewer _Septic
I
OWNED R/LEE�-�S'SEE:
C®NTRfACT®R:
Name LrD Gc i'ScPI A i2
Name: AP-140- WR7/841
Com pan .,
Add're's's: I
State: `la
Address://�OF,;SC:'�r-ice
.City: D h e So u..,1 6L- _State:
Zip Code: S a qS 7 Fax:
Phone No. 1 74- /*/cP- r/ Z 4
�'Ap Code:SfVff-5- ~Fax:
E-Mail: '
Phone No 77Q? -NSF/- YiO 7
Fill in fee simple Title HolderIonnext page ( if different
E-Mail Jr,,Di Jeg-&/A-rv",eo00.'+yo 0 Ci D/ •efiin
from the Owner listed abo v)
State or County License - 0-
if value of construction is 2500 j r more, a RECORDED Notice of Commencement is required.
SUPFIEMM AL CONSTRUCTIQ'N LIEN LAW f E-I M, ME iON:
DESIGNER ENGINEER: — Not Applicable
-M
MORTGAGE COMPANY:- Not Applicable
Name: J✓f�
Name: nrq-
Address:
Address:
City: State:
City:, State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name: A44-
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
is in
which 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, I do hereby agree thatd 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.
a
Signature of Owner/ Lessee/Contractor as Agent for Owner
F'gnature of Contractor/License Holder
STATE OF FLORIDA
STATE OF
_
COUNTY OF t- L)_X_Q V-6
FI- I A ,
COUNTY OF �( n
.
The forgoing instrument was acknowledged before me
The forgoing instr ment was acknowledged before me
this IBC day of �C� 20 153 by
this � day of C 2015(f by
0
(Name of person acknowledging)
(Name of erson acknowledging
O_X-ac�
(Signature of Notary Public- State of Florida)
(Signature of No ary Public- State. of orida )
Personally Known OR Produced Identification
Personally Known OR Produced Identificat4l/—
Type of Identification
Type of Id�rti icat'on , syA
Produced 1� �c sk°��
Produc d
6ommtsslon .
Comp ' ' Pa P °' CARLA NELSON
""• a of Floii(Ae 1).
''1 `��27
Commission No.�:� ar �2021
Commission M-FF 965535
Ab► GO Q8763
RE
SUPERVISOR
PLANS
VEGETATION.
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW'
REVIEW
'REVIEW
DATE
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RECEIVED
DATE
COMPLETED
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