HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONJ-
I
PLETED FOR APPLICATION TO BE ACCEPTED
CANNED Permit NWnlMr_4_`
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462
BY
welecoonfil
Iding Permit Appio
MAY 2 2 2018
:uma c-Uunty, Pormlttmg
Commercial Residential
PERMIT APPLICATION FOR: TOlSelect from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: Z 9(40 I
i
Legal Description: JP.a A C% •+,b ��T L 6 1 v 1 L aT Z Ll
Property Tax ID #: 3 42_S-_ 1
Site Plan Name:
Project Name:
Setbacks Front $ , Bac
DETAILED DESCRIPTION
�.Pe. �-
CONSTRUCTION INFOR
itiona work to e e or
0HVAC _ Gas
OElectric ❑ Plur
Total Sq. Ft of Construction: i
Cost of Construction: $ Z (a
NERWLESSEE:
. cal ;l- coo- t
Right Side: '• f
Left Side: NI N
WORK:
by
MATION:
n d under t is permit
'ank ❑Gas Piping _ Shutters
Ibing Sprinklers D Generator
S Ft. of First Floor: _
�'8 ~ Utilities:11Sewer 0Septic
Name--ZOA(
Address: Z9 Lol i=i 00.JC, . C;,,
City: P5 L— State:
Zip Code:. '34 9 a Z Fax:
Phone No. '712. (o34- 13\-7
E-Mail:
Fill in fee simple Title H, / Ider on next page ( if different
From the Owner listed above)
11+
Lot No. Z_ M
Block No. I g
QWindows/Doors
.01r Roof Roof pitch
Building Height: __
UUNTRACTOR:
aName:_ Wh;4e l„►,.,
Company:
Address: 61T W w �N-��•on s� ,-�,,
city: ?SL State:_
Zip Code: 311449S10 Fax:
Phone No. _77Z,. ZIz^ I►{ao
E-Mail: h h.o�ecp
State or County License: C3L O Z 5 11 b
F value of construction i $2500 or more, a RECORDED Notice of Commencement is required.
uC,lvlvtR/ENGINEER:
Name �Cw, ,,,ekK; N
Address: 144fie, TA&.
n
City: br4- eti,,,,1wr,-E
Zip: _ _a l_c, Phone
ISTR U C?"►J
_ Not
�A I"i l eI
S
yJ- 341.
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zlp: Phone:
ppucable MORTGAGE COMPANY: Ke4Not Applicable
Name: _
Address:
to- City:
1780 Zip: Phone: State:
_�C-Not Applicable BONDING COMPANY: x Not Applicable
Name:
Address:
City:
i Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Ap
I certify that no work or installation has come
St. Lucie Counttflflyy makes no representation tha
tructure. Please consult with applicable
ome Ow
In consideration of the granting of this reques
in accordance with the approved plans, the FI
The following building permit applications are
accessory structures, swimming pools, fences,
WARNING TO OWNER: Your failure to I
improvements to your property. A Not
before the first inspection. If you inten
commencing Work pr recprding your N
Signature of Owner/ Lessee/Contractor as
STATE OF FLORIDA
COUNTY OFF L_.jc,: ,E
cation is hereby made to obtain a permit to do the work and installation as indicated.
Inced prior to the issuance of a permit.
Pers Associationtrulesauthorize
bylaws or and covenants that may estrict or prohibit such
Iirs Association and review your deed for any restrictions which may apply.
d permit, I do hereby agree that I will, in all respects, perform the work
ida Building Codes and St. Lucie County Amendments.
Kempt from undergoing a full concurrency review: room additions,
,alls, signs, screen rooms and accessory uses to another non-residential use
cord a Notice of Commencement may result in your paying twice for
e of Commencement must be recorded and posted on the jobsite
to obtain financing, consult with lender or an attorney before
;ice of Commencement.
Owner
The forgoing instrument was acknowledged before me
this BH day of W4g 2003 I by
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF.
The foprgoing instrument was acknowledged before me
this f�day of_tlw}1 2018 by
W, I l�c►,.1 1�Ac�r7� 1
Name of person making statement I Name of person making statement
Personally Known -�_ OR Produced Identification Personally Known
Type of Identification OR Produced Identification
Produced Type of Identification
Produced
_4
ry Puc oFd�(Signs reof NtAig6re of Notry�ric lorCommkd
o� tate of FI66WU Commissio
? Liza D Mayfield
o
(Seal)
c'
My Commission FF 243393 I
o x fires 07/31/2019
=ov°Ue°�
Notary Public State of Florida
REVIEWS
FRONT ZONING SUPERVISOR p
I
off'
Liza D Ma teld
y mission FF 243393res 7L
fi
DATE
,
COUNTER REVIEW REVIEW
T
REVIEW
J ANGROVE
RECEIVED
I
REVIEW
DATE
COMPLETED
W.8/2/17
i