HomeMy WebLinkAboutBUILDING PERMIT APPLICATION-ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I.,
` 4�-1t/ Date: �' 0' I Permit Number: / O 4.
SCANNED
•E D
• St. Lucie County
Building Permit Applicatiori
JUN 2 0 2018
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort. Pierce FL 34982 Permitting De a r n t
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Re*denb� • _
r
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
;PROPOSED IMPROVEMENT LOCATION
Address: / o Z_ Ajz)� Av�-
Legal Description: W tm,+ , L i/e %��,s � . %�, �i c.S'rc, t�1^ t7�� � /�//f �. /�i���p �1� Z�
c// aia—ZiL Z/,
Property Tax ID #:/ t' - �� OPT - o-0 0 / Lot No. Z
Site Plan Name:,I'' Block No.
Project Name: /7'�ti �z? �4n�r✓%�
Setbacks Front Back: Right Side: Left Side:
DE WLED'DESCRIPTION' F WORK r.r
/ip/cce_�1114 4 /A&41 72- __02
ryLo�yav/�9 4 W� •rn�•' "/� z
/r'aPtys
CONSTRUCTION IN'FORIVIATION ' .' ` " 4 ; s
Additionalwork to be nertormedunder this permit -check a
E1HVAC !J Gas Tank ❑Gas Piping
apply:
Shutters
_
ows/Doors
/
b2of
Electric 0Plumbing Sprinklers E] Generator
y /L Roof pitch
Total Sq. Ft of Construction: &4T,6� S . Ft. of First Floor:
/S'6 Jo
Cost of Construction: $ as Oo�.oa Utilities:Cn
Sewer
0
Septic
Building Height: 17-
ODUNER/LESSEE h ;, ` a' Y ",
CQ,NTRACTOR
Name /4& -ram, 1411 a14—lei
Name: (a Cc a o
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Company:/90-9
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Address: /0"L 4o yc /&z-
City: 3�s�.-- >� � ti
state A- L
Address: 314Z.rS"/ ru-
Zip Code: 3�% SS• % Fax:
City: /!� `+i L'i
State C
Phone No.
Fax:
Zip Code: Fax:
Phone No. 7.72. -ZGa -S7.i-?
E-Mail:
Fill in fee simple Title Holder on next page (if different
E-Mail: CoA24 C
en_ �
bs
State or County License: ez e- o, a3S a'?
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City:
State:
Zip: Phone
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 efore
commencing work or recording vour Notice of Commencement. — � 11
Sign
as Agent for Owner
STATE OF FLORIDASTATE OF FLORID
COUNTY OF ���i''� COUNTY OF
The for
ggoing instru ent was acknowledged before me
this (O day of F•/ 201 by
Name of person m g statement
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State af o
Commission No.
The forgoing instrument was acknowledged before me
this _Lday of Vri/ 20/r by
Name of person mma . g statement
Personally Known OR Produced Identification
Type of Identification
Produced
:ZZ4�01�
(Signature of NotaryPu
NA1�tICKY CARL COCHRAN
10iblic-state of Florida Commission No.
Commission # GG 172136
My Comm. Expires Apr 26, 2022
u,. wl umsuah Witmsl NOWY Assn, 1.
REVIEWS I FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
Rev. 8/2/17
SUPERVISOR I PLANS I VEGETATI
REVIEW REVIEW REVIEW
RICKY CARL C.0 HLRAN
Netary Public - ANEVIFlorida
• = Commission # GG 172136
My Comm. Expires Apr 26, 2022
SEATURTLE I MANGROVE
REVIEW REVIEW