HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONA
ALL A IPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u
Date:' Tl 1 1� SCANNED Permit Number: i�O1 " d 133
BY
Ito Lucie County
SA NRECEIVED
Building Permit Application JUL 17 Z018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County-, Pl rt'_Ntrin9
2300 ! irginia Avenue, Fort Pierce FL 34982 — — -- - -
Phon I: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERK APPLICATION FOR: To Select from dropbox, click arrow at the end of line��--
PROPIOSED IMPROVEMENT LOCATION:,
Addre� - , r - 3 4 !G
b
Legal Description. b��lr%el, A 0 4l Ll a �� LP(P e•
- >> q b300` n0D
Propery Tax ID #- _ _ Lot No.
Site Plz ri Name: Block No.
Project Name:
Setba 1<s Front Back: Right Side: Left Side:
DETA LE'D DESCRI'PTION'.OF WORk:`.
r Imo. 51 • - �' 1°I� � `V�15)
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CON 'TRUCTfON INFORMATION:
itibna work to a er orme under this permit— check . a apply:
0 VAC Ei Gas Tank Gas Piping _ Shutters a Windows/Doors
OE ectric ❑ Plumbing Sprinklers El Generator 1:1 Roof Roof pitch
Total S . Ft of Construction: N S . Ft. of First Floor:
a�
Cost of; onstruction: $y Utilities: _Sewer Septic Building Height:
OWN;IER/LESStE:
CONTRACTOR:
Name v-
Address • b N Lli
Name: M WA �'\ e� P
Company: v=
City:
Zip Cod
Phone
E-Mail
Fill in file
from the
State:
!
e: Fax:
o.
Address: ,q (LA^s
City: I -+ // Stater
Zip Code: _Aq9 b Fax:
Phone No.� L7
E-Mail: wk
simple Title Holder on next page ( if different
Owner listed above)
State or County License:
If value bf construction is $2500 or more, a RECORDED Notice of Commencement is required.
Y
DESIG E ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name' t Name:
Acl&6 s- ' 0 V Address:
City: State: City: State:
Zip: Phone Zip: Phone:
i
FEE S11 PLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable
Name Name:
Addre s: Address:
City: City:
Zip: Phone: Zip: Phone:
I
OWNE / CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify iihat no work or installation has commenced prior to the issuance of a permit.
St. Lucie Count
makes no representation that is granting a permit will authorize the permit holder to build the subject structure
' which is iconflict 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 considration of the granting of this requested permit, I do hereby agree that I.will, in all respects, perform the work
in accord ince with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The folio' ing building permit applications are exempt from undergoing a full concurrency review: room additions,
accessor 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
improv ments to your property. A Notice of Commencement must be recorded and posted on the jobsite
before he first inspection. If you intend to obtain financing, consult with lender or an attorney before
cnmme ring work nr recnrding vnur Notice of Cnmmencement-
Signatu�
e bf ner/ Lessee/Contractor as Agent for Owner
Signature on actor/License Holder
STATE;
OF FLOR
STATE OF FLOR AII ,
COUNTY
OF `�
COUNTY OF (ail CitO
The for
roing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this
day of 7TM L 20- by
this _aday of ZhA W 20 tr by
Name c
f person making statement.
Name of person making statement.
Person'
Ily Known _V OR Pr
Personally Known 0( OR Produced Identification
Type o
I Identification JAMIEPUGH
Type of Identification
JAMIEPUGH
Produc
d :°r'YPo MYCOMMISSION#GG047204
Produced o,��P�a ,
h GOMMSSION #GG047204
EXPIRES: NOV 14, 2020
Bonded through .1st State Insurance
n EXPIRES: NOV 14, 2020, Bonded through
st State Insurance
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( gn
re f Notary Public- State of Florida)
(i at re Notary Publlicf- Statte��oo�fFloridaCommi
LionNo. b� (Seal)
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Commission No.6-6-6`4 t2pq (Seal)
REVI'jI
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FRONT
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SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW'
REVIEW
REVIEW
DATE
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RECEI
,ED
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DATE
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COMP
ETED
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All APPLICABLE INFO MUST BE LOMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
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:
Ili
50
Address:
Legal Description:
I'
i
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Additional worK to be performed under this permit — check all that apply: I
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
I
i
Electric _ Plumbing _ Sprinklers _ Generator _ Roof P.
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
j
Cost of Construction: $ Utilities: _ Sewer _ Septic Building Height: 1!,
"
ft
n
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«:
Name
Address:
Name:
Company:
Address:
II
City: State: _
Zip Code: Fax:
Phone No.
E-Mail:
II
City: State:
Ii
II
III
Zip Code: Fax:
Phone No
E-Mail
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
III
State or County License
III
11 If value of construction is 2500 or more, a RECORDED Notice of, Commencement is required.