HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALLi, PLICABLE INFO MUST BE COMPLE FED FOR APPLICATION TO BE ACCEPTED
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S4; Lucie4u RECEIVED
Building Permit Application JUN 2 9 2018
ning and Development Servkes
8ulIngandCodeRe 5koonDfvfslon ST. LudeCounty, Permittinc)
23W Virginia Avenue, Fort Pierce FL34982-
Ph¢ ne: (772) 462-1553 Fax: (772) 462-1578 Commercial _ Residential
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PE MIT APPLICATION FOR: To Select from dropbox, click arrow at the end, of
Dint:
PRO
,- POSED`t11�IPRQVEMENTaLOCAT10�1•3 ' � j ` * ` ''
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Legal Description: AM
ill -
PropprtyTaxiD#:._ QIS - �a 1- OCj� Lot No"-nbb
Site P,I�an Name: e
li -&-R-. Block No;
Prof -I t'.-me: -e Q e I
Setb! cks Front /= Back: 0
Rlght Side: /O _Left Side: �O �
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D1iLED DESCRIP�fIOiN QF WORK `' " `
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cnecK au ujin; apply:HVAC E*1�T G s Tank s Piping Shutters _ windows/Doors
Electric _ Plumbing _ Sprinklers Generator _ Roof Roof pitch
Total I . Ft of Construction: Sp, It of First Floor:
Cost Construction: $ 00 sti Util' - Ob• es: —Sewer _ Septic Building _Height:., _
�4
City IJ (� p Ott- �'T_ _' L �c & state: -
Zip Cole: _-Jk,4iS-4 Fax:
Phone No. 6S'i-DSO- 00'A2
Rif in" i e simple Title Holder on next page (if different
from j he Owner listed above)
If va4 of .00ns&uction is $25W or more, a RECORDED Notice of
Name: AJANN
Company: _Q�
Address:362_G SLJ MAR_TN uWY
COY- - State:T
Tip Code: O
Phone No. - 7�V_wz_'
E-mail:
State or County License:
Fax:
F403t)o %T'lbrs
i
= DESIGNE ENGINEER'S Not A , lica , e ''' `
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MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address-
Address:
City: State:
City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE.96LDER: Not Applicable-
BONDING COMPANY: Not Applicable
_
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zi Phone:
ONER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation,as, indicated.
I Iicertify 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 ppermit holder to build the subject strbcture
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 restricfionswhich•may apply'
Ili 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,
. a��cessory 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. payingtvAce 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
c6mmencine work or recording vour Notice of Commencement.
ATE OF FLORID STATE OF FLORIDA,)LINTYOF ^Slip �, neI - COUNTY OF �,UJ 1} C�„JN-f-
ing instrument was acknowledge fore me
day of ' - e __ by '
of persch acknowledging
ature of Notary
mallyKnown i
of identification
nission No.
WkW
TE
Theforgoing, mstrl ntwas acknowledg�efore me
thi I day of 20 by .
. `k" oI � Yam•* - Fri►-«
(Name of person cknowledging )
VIA
State of Florida } (Signature of Nolarj PublicState of Florida)
tate of Florida -Notary Public
Co ion # GG 190282
MC
omission Expires
February 26, 2022
FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
Personally Known %C OR Produced Identification
Type of Identification Produ
Commission No. G, e`+S Florida -Notary Pub
fission # GG 19028',
My Commission Expires
February 26, 2022
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW . REVIEW- REVIEW REVIEW
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