HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLE i r.0 FOR APPLICATION TO BE ACCEPTED
Date: rill m) ' is Permit Number: 1 J
it ISCANNED
i5 BY RECEIVED _.... .
_ St.'L.Ur4e COBS
JUL 3 0 2018
Building Permit Applicati' n Lucie county, Permitting
Plannin and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone� (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address: 0-3 rr vj
Legal Doscription:
Site PI
Projec
Setba
T
Commercial Residential D(�
yTax ID#: 6 4- 5
n Name:
Name: p
<s Front I.i fr Back: 00 fight Side: eft Side: 1�
0
ional work to be pertormed under
Mechanical _ Gas Tank
L Electric _ Plumbing
Sq. Ft of Construction: Q LYU
of Construction: $ 03t-70
s permit -
Gas Piping
_ Sprinklers
Lot No.
Block No.
all that apply:
Shutters _ Windows/Doors
Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
Na"me
me
r-
`
Adress:
% J 0-3
(,n u.a nx . da/�
Ci''ldf y: a%"7�"i�P�
State: i=C:
Z�b Code.
3 d .S I
Fax:
P one No.
_2 v� -
% 9- 02 S
E Mail: ,1»Pa
6
.,6C)oc4C.- FV(0,3C)"a-cc
F�Il in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: )cue _. -- �1/k� 61 d_0 XL—
Company:
Address:�U3"a,��i.�✓�� v2
City:-�i State.
Zip Code: Fax:
,Phone No a SI 9 -'a ',S737
E-Mail . �oe- ® SL,C.(3- aot.i,_F— eLL
State or County License
If
of construction is 2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:
Name:
Address:
City:
Zip:
FEE SIMPLE
one
Name:
Address:
City:
Zip: Phone:
Not Appl,ical
_ State:
Not Applicable
MORTGAGE COMPANY:
,
Not Applicable
Name-. ..
—
Address: .
City: -
State:'
Zip: Phone:
BONDING COMPANY:
Not Applicable
Name:
Address:
City:
Zip: Phone:
UWNtK/ GUN I KAG I UK AFFIUVIT: 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. { i'
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, II
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 forll�
improvements to your property. A Notice of Commencement must be recorded and posted on the jobslte
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording ypur Notice of Commencement.
Sign ure of O ne e e as Agent for Owner
Signature of Contractor/License Holder
i/Contractor
STATE OF FL O A
STATE OF FLORIDA
COUNTY OF . LUo t-t_.
COUNTY OF
The �rgoing instru ent was acknowledge before me
The forgoing instrument was acknowledged before me
this o� day of 20]_ by
this day of . 20_ by
(Name;of person acknowledging)
(Name of person acknowledging)
(Signature of Notary Public -'State of Florida
(Signature of Notary Public- State of Florida )
/
Personally Known OR Produced Identification ✓
Personally Known OR Produced Identification
Type of Identificat' f� '
Type of Identification
Produced kJ
Produced
K
Commission No. .=o`'"�'�°�'(AREN S. NIELS
,A (Seal)
fission No.
e of Florida -Notary
p`a` Commission # GG 2p
ubliC -
484
""11
June 12 x
2 �
fires
REVIEWS
FRONT
ZO
NS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
RE I
REVIEW
REVIEW
REVIEW
DATE
of
RECEIVED
g1
DATE
COMPLETED
Rev. 7/2014
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