HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONV
PPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:,-tt cJ� d S0_0111
Building Per
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Corn
BY SC �� .� RECEIVED
$�U
nit Applicatio MAy 17 Z018
ST. LuCie County; Permitting
al Residential X
PERMIT APPLICATION FOR: Other
PROPOSED IMPROVEMENTLOCATION,w�':
.x�
....,
.
Address: 7111 Gullotti Place Port St Lucie FL 34952
Legal Description: ST LUCIE GARDENS 24 36 40 BLK 2 S
N 330 FT OF E 330 FTOF LOT 8 (3.75 A
FT OF N 990 FT OF LOT 6 AND S 165 FT OF
(MAP 34/24N) (OR 3211-1256)
Property Tax ID #: 3414=501-1006-250-4
Site.Plan Name: Bradley Tree House
i
Project Name: Kids Tree House
Setbacks Front Bac • �1 �� Right Side:_ Left Side
As -built -drawings for existing Kids tree house.
[--IHVAC-
❑ Electric ❑ Plumbing ❑Sprinklers II Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ 200.00 Utilities: Sewer F]Septic Building Height:
Lot No. 6
Block No.. 2
"Shutters
❑ Generator
❑ Windows/Doors
❑. Roof
®UVNE;R�/LESSEE.: • "�
. C®NTR%�CT®R':
Name Josh Bradley
Address: 7111. Gullotti Place
City: Port St. Lucie State: FL
Zip Code: 34952 Fax:
Phone No. (772) 370-6424
Name:
Company:
Address:
City: State:
Zip Code: Fax:
Phone No.
E-Mail:
E-Mail: Joshpbradley@comcast.net
Fill in fee simple Title Holder on next page( if different
from the Owner listed above)
State or County License:.
If value of construction is $2500 or�more, a RECORDED Notice of Commencement is required.
r_
:JPPLEMlENTAL C®NSTRl1CTION LhEN LAUD IN'F®'RMATI2N:
DESIGNER/ENGINEER: _ Not Applicable
P, Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 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, screien 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 inspection. If you intend to obtain financing, consult with lender or an attorney before
cnmmen _ neq work or recordine vour Notice of Commencement.
i
i
Signa re of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
ST E OF FLORIDA
STATE OF FLORIDA
COUNTY OF Sir . %_uC. %'@ �
COUNTY OF
The for oing instrument was acknowledgedbefore me
'I'n0\�
The forgoing instrument was acknowledged before me
this day 20_ by
this day of , 20by
of
'S�51.oq, tc
Name of person making st4tement
Name of person making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced `F�, �D t-
Produced
(Signature ry S ato for NA uvc
Si nature of Nota ubii,�:� MARIE �Gp22023
�ry1 .•'r v gu y flIS5
Cc), 10N 2p'p
`"(Signature of Notary Public- State of Florida
Y )
: y 16
Commission No. SeAA �'Q %W S57 cem�r nderMle
publieU
Commission No. (Seal)
ded-0 ru P7°tary
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17