HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: DI A4 0 1 scpaw Permit Number: �105� aS6q
' BY
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- studecoll0v RECEI�lE®
Building Permit Applicati n MAY 2 2�18
Planning and Development Services
Building and Code Regulation Division ST. Lucie COun�y} f�5_rlfilttir�9
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential Y
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line S V
PROPOSED IMPROVEMENT LOCATION:" lf4
Address: 7 0/ 1)4��W PAflX !Tl/%, /= T, f %riZCF /Z
Legal Description:
1 i ry +
Property Tax ID#: L3 0 a
Site Plan Name:
Project Name:
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Setbacks " Front -f' Back: Right Side: �� Left Side: a�
DETAILED DESCRIPTION OF WORK:
3 GFPPom �2 9,4Vf I C-7ARu6c
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Lot No.
Block No.
CONSTRUCTION INFORMATION:
Add i ona I work to be nertormed under this permit —check a apply:
HVAC 0 Gas Tank ❑Gas Piping Shutters L2j, Windows/Doors
Electric Plumbing Sprinklers 1:1 Generator M Roof /� Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor: %i� 1
Cost of Construction: $ GGD(1 Utilities: Sewer LJSJ Septic Building Height:
/Y� /
OWNER/LESSEE:
CONTRACTOR:
Name lGt�?f �IA3%rfJ7_F�/t
Name: � ICICF ///f,It 7V-1 /"-
Address: 7 d,! ' (71(_ S /
Company:S 7 LGC?Y 1-6+12--r /=c/[ /a6irj'WA._?7`>
Address: %.?
City: % e-72,21<< State: 64
Zip Code: 1-09(_C' Fax: 7 7,�? —41777
Phone No. '7 7 2 4/,,-
City: 1T fz411C/' State: f �
Zip Code: 31-0" _O Fax: 77V - lltl, q -'(777
Phone No. 77d- S77 ///7
E-Mail: �SF�1/ S%LG/C'/L/,¢�li ifT , G%��
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: �Y_ OSFI�l LED S% 1C4CF NA? %�7 oOF (7
State or County License: /ASS, 1-09. 1
/4774LC li EJ
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:bikdP ' IObsF
MORTGAGE COMPANY: A�/- Not Applicable
Name:
Address:
Address: y4/57
City: E7 PTFxct- State: tr-1-
City: State:
Zip: 3e-/94/6 Phone 71r9— y61— /15/a
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 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 your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA_
I_uU'E✓
STATE OF FLORIDA
COUNTY OF
COUNTY OF "::�4
The forgoing instru'mp ent was acknowledge before me
The for oing instru ent was acknowledge before me
this day of _MG3[d8 20 ► 6 by
this day of 20 by
/Robes-1 • W'�Oyo
1 0P D CMG. lsyg>"
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
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tY! mot' W U Vt' U �.
L�,6L
(Signature of Notary Publi `turf Fld � I�ubiic state of Florida
(Signature of Notary4Publ1ic-ya&Flor jPublic state of Florida
Donna Lea Askman
vy,_., ,"c19 My m ission GG 174054
Commission No. � G S o • c� ex�lo9lzozz
� Donna Lea Askman
cMI fission GG 174054
ommission No. �7ylsF
Expires 01 /0912022
AO
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
tev. 8/2/17