HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONf
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ALL APPLICAB E INFO MU T BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: .Permit Number: 4 1j
Sol; ��e, r�it Application MAY 3 0 2018WON g,
Permitting Department
Planning and Development Services •5t. Lud County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Selec from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:TS
1
Address: — 0 l��
Legal Description: A� /�/t°S I rCJ) �Lo ►�
Property Tax ID #: 'S L,117 —
Site Plan Name: r 1
Project Name: i 6
Setbacks Fro. Back:
�0 0 —0 Lot No.�
Block No.
DETAILED DESCRIPTION �OF WORK:
New and tMPOVt-rY60-r--�
2_C0-Ar9CtrCt9.C'
CONSTRUCTIOWINFORMATION.:
Ll tial work to b e nerformed under tis permit -c ec a apply:
MH C Gas Tank Gas Piping _ Shutters Windows Doors
_ DIP'
Plumbing Sprinklers
CqElectric
1:1 Generator Roof S Roof pitch
I' _
Total Sq. Ft of Construction: '�` '��'"�� 54 q5SCI nFt of First Floo : �55
Cost of Construction: $ 5�0 I ryJ4. I Utilities: —Sewer 12Septic Building Height: P �& m P-14
OWNER/LESSEE:
CONTRACTOR:
Name
i��
Name:
KaW-
Address: kAaCY-) Cx1�& I'pv
Company: C
City: s �ii State: L
Zip Code: Fax: 'I
Phone No. -35101q_b3-.64-7(P
Address: CJ�ISIV
'nnQ'S�
V ifV^pL
City: State:L
Zip Code: ��� (�D Fax-7-21- Z(- o�{
Phone No.
E-Mail:V�
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:l
State or County License:
If value of construction is $2500 or more, a
Notice of Commencement is required.
08-
S.UPF:LLM;ENTAL CO.NSTRUCTION.'LI.EN.'LAW INFORMATION
DESIGNER/ENGINEER: _ Not Appl cable
MORTGAGE COMPANY: Not Applicable
Name: &EIR
Name:
Address: 3 ics(1S 2
Address:
City:PA.Vriib h C- 'y�6eosState: c -
City: State:
Zip: 33-41K Phone
Zip: one:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _ of Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Applicatio 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 gra ting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owner sl 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 pe' mit, 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,lsigns, 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 pbtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Signature of Owner/ Lessee/Contr 0as Agent r Owner
Signature of Contractor/Licens Ho r
STATE OF FLORIDA
COUNTY OF I I-U-� I
STATE OF FLORIDA
COUNTY OF s l-1teA�
The forging instrument was acknowledged befo e me
this ZS day of M 2019 by
The forgoing instrument was acknowledged efore me
this fCdayof f{'!1 2015' by
Name of person rpaking statement
Personally Known OR Produced Identifi ation
Name of peaking statement
rson
Personally Known t�OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
a
(Signature o �y� uVfjcprida)
Commission # FF 153351
Commission tember
Boded T1.0 Troy Fein Ins— WOO 7979
(Signature o gty��y�Pu �� rI a
_�: *: Commission # FF 153351
Commission cam. :; Ex iresSeptember2,(2DM&I)
',pF n.°.•`� Bonded Thru Troy Fan huumice 8003857019
REVIEWS
FRONT
ZONING
UPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17