HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APF
Date:
INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
%A Permit Number:
SCANNED
�, Ar SY ED
St. ,'Lurie +S i lty RECEIV
WW Building Permit Applicati n jug 18 ,;
Legal�DIscription: �Q) t < < l AYVM S A DO 1�( '2 1 L 1 W low n7� �_1 Q,,, 0 A) o.6 A . 14
Property Tax ID #: 6062- <200- ,S_ Lot No.
Site Pla fflll Name: Block No.
i
Project �I ame:
Setbac4 Front Back: Right Side: Left Side:
(- f /,.r�,��-e�� � -�-6crcC� �►��lu r 1 Qtp, Of Gate gar CAP � f� l �rt,���/z '�ca
I►,
Total Si
Cost of
ai worK to De perrormea unaer finis permit- cnecK ail tnai apply:
chanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors
ctric _ Plumbing _ Sprinklers _ Generator Roof Pitch
Ft of Construction:F1�"D
instruction: $ /,5006 o-C7
Sq. Ft. of First Floor: _
Utilities: —Sewer —Septic
Building Height.
Name
Add reslll: Company: 0 _ ® ' x t G•
City _ Stater(. Address: 00
Zip Co IdIlle: 34� g� 1 Fax: City:x� �c!'cp State:41.16
Phone No. % 72 - '11e1Yf -- / S l'L Zip Code: Fax: 772 -40� -'M�
E-Mail:. Phone No 72 2 - -S%a—,,�733
Fill in fgl�le simple Title Holder on next page ( if different E-MailXj- iGa_C_ l 7/770 4o I
from tf�'ie Owner listed above) State or County Le
If value of 1onstruction is 2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:' _Not Applicable
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 accordancewith 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 workx recording our Notice of Commencement.
a
Signa re of Own Lessee/Contrac ent for Owner
Signature of Con ct icense Holder
STATE OF FLORI A
STATE OF FLO%DA
COUNTY OF 5 L Jc`��
COUNTY OF 1-yc-�-�
The for oing instrument was acknowledged before me
this \ day of �J 1y 20 �� by
The fo[going instrument was acknowledged before me
this jq day of20E by
,
x
i
i
VJ�,\\.av�+ C1��►\�dVX
(Name of person acknowledging)
(Name of person acknowledging)
(Signature of Notary Pub Ic- State of Florida)
(Signature of Notary ublic- State of Florida )
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identifi ation
L ` �
NType of Identification em c ��--- RIE GIVENS
-
�- a NNAMA
Produced J) T.ca �_ "
pEANNAM ARIE GIVENS
# GG 022023
e•.� n
roduced �„ DEA GG 022023
a o :;�'•-. y COMMISSION #,
� M�p =S: pecfff 16, 7A20
`tS�6+'��
�MMISSION
+ of~"PU
Commission No. 6�� _ (� ecem�c16,2o20
Es: D
�; mmission No. tl�R!r 1?u 1irU" ecwnd
cP e��6u Notary
ty public Undamj
BnndedThNWo ro
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d Ji.�yII.'.iV+'Swr
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
,
Rev. 7/2014