HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLE'itli FOR APPIICATION TO BE ACCEPTED
Date: to I- 1i Permit Number:
KNIRM, &,a A A A A I r— r't
mfffimm' RECEIVED
RECEIVED
............. . ....... - ...... .... . Building Permit Applicati n
Planning and Development Services JUN 0 12018
Building and Code Regulation Division 9T.L Permitting
ucie count ,
ST. Wde County,
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR:
Address: —1,-) 0
Legal Description:
I
Property Tax ID #: 31
Site Plan Name:
Project Name:
Setbacks Front— 03
1_2
0 31.0
5,
Back: :2 3 1 — Right side: 9 q..' Left Side: JO "
Lot No.
Block No.
SOO 0^
till.,
-1
Qro�i 0!�007A q- y'l ff, ql'tl ];.,Ie _Y
4o
aen e-e 4 Llr 4,161
B
rt'k
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ik
_,-Hap _ionai worK to De perTormea unaer tnis permit - cneCK -aiitnat appiy:
..Mechanical -"G k as Tank t/"Gas Piping Shutters Windows/Doors
Electric Plumbing Sprinklers,- Generator Roof Pitch
Total Sq. Ft of Construction: I Sq. Ft. of First Floor:
Cost of Construction:$ A1y5_0, 0 e> Utiliti �ls: Sewer — Septic Building Height:
CUN"l 0
01 R..'
Na`meM Z2
Name Ai(
r)y:—. 11 1. 's" "' -,
Comp _DC
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Address:-' 1'�� 6"9' qk CX ii e
City: 0.r4. 4 li� State:,&_
Address: I S70,) SV /h
b QC '0 1
Zip Code: 3V9Yl Fax:
City:
Stater,(_
Phone No. A1111
Zip Code: Y�Y6
Fax: 77,)-,�97 - ? V3'
E-Mail: Alld
Phone No 5-�7-
gTq3
Fill in fee simple Title Holder on next page ( if different
E-Mail irtO 1A A. & 7 49
11-ve ed, -'1 -e_4
from the Owner listed above)
J
State or County License Saw
L P 179 y5_"
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:, _ Not A
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: (cable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:.
Address:
,City:' " `' State:
Zip: Phone:
BONDING COMPANY: Not Ap licable
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.
Signature of ofner//"�ssee/Contractor as Agent for
STATE OF FLORIDA
•"""•
COUNTY OF
The forgoing instrument was acknowledged before m
this day of 20If by
N
Z
C'0
p
(Name o person acknowledging)
(Signature 6fAotary Public- State of Florida )
Personally Knowr V np P�-'a 'mcB`eF
Type of Identifica i� j 4,,, SYLVIA L MARTINEZ -
Produced :•• •= Y COMMISSION # 00080799
EXPIRES March 08, 2021
,""
Commission No. S
;nature of Contractor/License Kolder
FATE OF FLORIDA
'
)LINTY OF Q Yl
rn -�
xo
v
ie forgoing instrument was acknowledged before me
�^
is:�/kday of MCI V 20f f by
En N
o
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!� e 60
x
ame o Tperson acknowledging)
N
(Signatu of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of A
Produ eld entification SYLVIA L MARTINEZ
mycomISSION # 00080799
Commission NO. '•:�, ..�� EXPIRSe��rch08,2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
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DATE
RECEIVED
DATE
COMPLETED