HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL
INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l 1
SCANNED Permit Number: � (� !-bqm'
BY
RECEIVED
sg. Lucie count
' JUL 17 1018
Building Permit Application Permitting Department
Plan�l ing and Development Services St. Lucle'County
Building and Code Regulation Division
230 Virginia Avenue, Fort Pierce FL 34982
Pho�e: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERM IT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION.
Ir -".
d Addr s: � i �r Le
G '1
Legal�escription: f 6 r f �yf'ce- Sh 0 re e,—yl1 ,4 1
Proprty Tax ID #:
Site Plan Name:
Project Name:
Setbcks Front
6-(6)-O061-000--0
Back: Right Side: Left Side:
Lot No. e
Block No. !j
DETAILED DESCRIPTION OF.WORK:
r\* V-4 %�- I-1--G�e� . RQ V YNUVR ,I 4t v I oy- g al �L.[� f6
� J
CONSTRUCTION INFORMATION: .
i }ona wor to a er orme under this permit - c ec a apply: yV �—
HVAInC Gas Tank ❑Gas Piping _ Shutters ows/Doors
116- Electric I�Plumbing []Sprinklers ❑ Generator ❑ Roof Roof pitch
Total q. Ft of Construction: 40 S . Ft. _ of First Floor:
I�
Cost Construction: $ Utilities:❑Sewer Septic Building Height -
Owl,
ER/LESSEE:
CONTRACTOR:
Nam
✓ ty-\ kv- Z-frvejjs
Name: c5C ual c, f- oowy
q t' 3
T 65-L.41 Ie,N s CWe, L-A,
Address:
City:
Company:
Address:
�C< 0n State: MD
'r
Zip C
$ de: 24(p 6Fax:
City: State:
Phon
No., !'(0— S Z - 'I-+q13
Zip Code: Fax:
E-MaAFillin
l: l e- • <"+e,✓Cr\S rh06 f✓ d h1
Phone No.
e simple Title Holder on ext page ( if different
E-Mail:
e Owner listed above)
State or County License:
IIf valu of construction is $2500 or more, a RECORDED Notice of Commencement is required. I
SUPPLEMENTAL
CONSTRUCTION LIEN LAW INFORMATION:
DES
Name:
Add
City
Zip:
IGNER/ENGINEER: _Z@ot Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
ess:
State:
Phone
I
City: State:
Zip: Phone:
FEE
Nane:
Add
City
Zip: 11
SIMPLE TITLE HOLDER: of Applicable
BONDING COMPANY: _L,-Ilot Applicable
Name:
ess:
Address:
City:
Phone:
Zip: Phone:
:R/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
that no work or installation has commenced prior to the issuance of a permit.
County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
'e. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
deration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
dance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
owing building permit applications are exempt from undergoing a full concurrency review: room additions,
ry structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
IING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
vements to your property. A Notice of Commencement must be recorded and posted on the jobsite
the first inspection. If you intend to obtain financing, consult with lender or an attorney before
encine work or recordina? vour Notice of Commencement.
Sign
u e O n r/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STA
COUNTY
E FLORIDA t_ -
OFC.�9.�
STATE OF FLORIDA
COUNTY OF
The
or oing instru ent was acknowledged before me
The forgoing instrument was acknowledged before me
this
� day of 13t. .20 by
this day of 20_ by
me o erson making statement
Name of person making statement
Personal Known OR Produced Identification
Personally Known OR Produced Identification
Typ of Identification
Type of Identification
Pro laced
M. a -- L
Produced
(S'
a re of Notary _Public�AAate cf;Florida,)
(Signature of Notary Public- State of Florida )
-i ........... LASHAHNA INGRAM
Com
ission No. z� '? a �: Notary PuL(5eaotate of Florida
Commission No. (Seal)
« • E My Comm. Expires Dec 20, 2018
9 . �9 Commission 4f FF 177249
FRONT
ZONING
RE
fIEWS
S U P E R71"St R
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATP
RECEIVED
DAIj
CO
PLETED
a
tev. 8
2/17