HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONJ
All APPLICABLE INFO MUST BE COMPLETER.APPLIOATION TO BE ACCEPTED �� r
Date: a� �'6 Permit Number:
SGANNhu RECEIVED
Build ng��e�mit Applicati n MAY 2 9 2018
Planning and Development Services ST. Lucie County, Porno wng
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 COmmerCial Residential X_
PERMIT APPLICATION FOR: a
Address: Y7�_,
Legal Description:
Property Tax ID #:
Site -Plan Name:
Project Name: _
Setbacks Front
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IeCZ I F
'Ay''S-3''sI- 060G —666 —
Back: RightlSide: Left Side: 0
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Lot No.
Block No.
Aaamonai worK to oe perrormea unaer tnis permit cnecK aii mat apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters —Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: 2 � �� Sq. Ft. of First Floor:
p
Cost of Construction: $�) �1 % Utilities: _ Sewer _ Septic Building Height:
OWNERS/LESSEE:
C(7NTRACTGIR
Name (��%�,.4vr, 91 L(4& 4-rS;f
Name:
Address: %�1 lAN 'u r
Company:
City: Fok4Pi�sl_ce=- State: &
Zip Code: 34/ % g2 Fax:_I I
Phone No.. 63 (o is l `/ — c,� �i 9
Address:
City: State:
Zip Code: Fax:
Phone No
E-Mail: (� / /�S �%� /rA , (_0kn
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above) I
E-Mail
State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
SUe 15mv ENTAI Cm +TRfl1CTl4 L EN I.AW INFORMAT
ON;
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address: - -
City: State:
Zip: Phone
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: 'State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:.
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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.
� YL11,
Signature of Owner/ Lessee/C tr -tor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
OF FLORIDA
COUNTY OF S �- . L-z
_STATE
COUNTY OF
Theoygoing instrument was acknowledged before me
�-l1
The forgoing instrument was acknowledged before me
this day of Y`n" 120 \ by
this day of 120 by
r�l 5
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 �s �- 1D VF'" at ��� .
Produced
D
ar EANNA MARIE GivENS
nAy COMFvIISSION
# GG 022023
,; EXPIRES: December 16,
2
Bonded Thm 020
(Signature of Notary P lic= S`ta of~Fo3�r
(Signature of Notary Public- State of Florida )
Commission No.oyks., 14 i (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
,
DATE
COMPLETED
s4
Rev. 8/2/17