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Home My WebLink AboutBUILDING PERMIT APPLICATIONALL AP�PLI ABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date Permit Number: f G SCANNED BY RECEIVED st.1.? cle COi v* Building Permit Application AUG o 12018 PlannLg and Development Services ST. Lucie Co nty, Rormittin BuildllI g and Code Regulation Division 2300�i/irginia Avenue, Fort Pierce FL 34982 PhojIlr: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PER IT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: i (� Ovi2�C() aAM A& U, Far� �HaH ci Legal Description: &Q!e s Uwe _') Y) l � � �' �� %- 2l" I ©i ��t)V 3a 0 r3 - �� 1 ,, it� F Propeity Tax ID #: �� _-I o� - r) MCA `D Lot No. Site Plan Name:7Tyrnmin(3 'ReS(C1eM _ Block No. %Z. Proje II� Name: ��SS CI'Qxlce' Setbacks Front Back. Right Side: Left Side: DETAILED DESCRIPTION OF WORK: n �5h;()5 )e rco'( to 1 5nAploc k &key CONSTRUCTION INFORMATION: AddiL.11onalworktobenertormedunder this permit -check all that apply: i OHVAC _Gas Tank Gas Piping _ Shutters Windows/Doors I �_ Electric 0 Plumbing Sprinklers Generator Roof ®. Roof pitch Total q. Ft of Construction: ` 471 CIS S . Ft. of First Floor::1-95 Cost o Construction: $ �J Utilities:CnSewer Septic Building Height: . OWN ER/LESSEE: CONTRACTOR': Name Qk0 -Tumcnino Addr�iss: � City: fl m State: r- Zip Code: 0 % 01 Fax: P h o n No. `1 - E-M I: r1 Name: 1 k'm (V1eV C_d—_ Company: (f R��eLA ��3t(�-tr'i cAl. � Address: 5,5w-i ZE bid (Xl Q,yklA)l1 City: Sh)apc+ State: Zip Code: 3H qcr1' Fax: Sgs "-i Phone No. -1- 1,- ?4� e ''l(9(00 i Fill in from fee simp a Title Holder on next page ( if different he Owner listed above) E-Mail: State or County License: If val 1I of construction is $2500 or more, a RECORDED Notice of Commencement is required. 1 SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DES�GNER/ENGINEER: Name: Addriess: City. Zip: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Address: State: Phone City: State: Zip: Phone: FEE Na rne: Add City: Zip: I IMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Name: ess: Address: City: Phone: I Zip: Phone: OWN R/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I certi V that no work or installation has commenced prior to the issuance of a permit. St. Luci' County makes no representation that is'granting a permit will authorize the permit holder to build the subject structure which i in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structuile. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In cons deration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work in acco dance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The fol wing building permit applications are exempt from undergoing a full concurrency review: room additions, access y structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WAR I ING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for impro,ements to your property. A Notice of Commencement must be recorded and posted on the jobsite befor the first inspection. If you intend to obtain financing, consult with lender or an attorney before com ncin k or recording our Notice of Commencement. i I Sig { re of n r/ Lessee/Con ac as Agent for Owner 8ignaturegfVbntractor/Licens older I STATE OF FLOR L� STATE OF FLOR D COMITY OF�� 7/� i COUNTY OF The fdFgoing instr ent as acknowledged before me this Q day of 20�-by Name of person Vhaking statement Perso ally Known OR Produced Identification Type f Identification The forgoing instru en was acknowledge before me this � day of 20 /& by r Name of pe o making eme t Personally Known OR Produced Identifi Type of Identification p Produced !o; w (Sign�ilur o! tate ot Florida (Signa • - State of Florida ) T D a4 FiYAN LYNN COLLUPY ° M o Z Comm ssi ri 0 's MY COMMISSION #l5MA227 Commission No. (Sea w 9 EZ EXPIRES October 21, 2018 w v� Z o z140713e8•0153 FloridallotaryService.com p IN -n REVIIFWS FRONT ZONING SUPERVISOR PLANS [REVIEW EGETATION SEA TURTLE ZAA`N�Fr COUNTER REVIEW REVIEW REVIEW REVIEW a AWE% DATE RECEI, ED DATE COMPLETED Rev. 8/2%17