HomeMy WebLinkAbout0502-1081- BUILDING PERMIT APPLICATIONI pl
FOR -APPLICATION TO BE -ACCEPTED
ALL APP (CABLE INFO MUST BE COMPLETED
9
0 Date: l SCANNED Permit Number: V V
1111111111111h BY
St. Lucie (Comm R ml-Pm C E,,`l V E D.
- Build ing.Permit Application AUG ® 3 2018
Plannin and Development Services
Buildin'and Code Regulation Division Permitting Dep-= tment
gini'a Avenue, Fort Pierce FL 34982 t. q C i U f � t �� o L
Ph nel (772) 462-1553 Fax: (772) 462-1578 Commercial _.. _:.__,. R -
I
PERM IT APPLICATION FOR: To Select from dropbox, click -arrow at the end of line
PROPOSED SED IMPROVEMENT LOCATION:
Addres
it l si� c lFrye'-- 0
Legal
D scription: Uri P. J� C1N/ 7 S, Q����S' ..._.LaT �.5, (, sir... 2-?7-X-" ISa 5 --
I
Prope
Tax ID #: 3y19 - 51/0 - C�d- GOB ,6 Lot No.
Site Pla
tName: Block No. J
Project
ame: 04"r d 9rig�
Setba
front Back: Right Side: Left Side:
DET
1LED DESCRIPTION OF WORK:
7,6
r�
CON ITRUCTION INFORMATION:
Additl'onal
work to ((e��ejj orme under tispermit-check all that apply:
HVAC —Gas-Tank []Gas -Piping _Shutters F endows/Doors
lectrie 0. Plumbing- O Sprinklers 0-Generator _ Roof Roof pitch
Total
' q. Ft -of Construction: .1Z� �_ S '. Ft. of First Floor: ��� '_
Cost'
Construction: $ i�D'�G'd Utilities: _Sewer_o"Septic Building Height:
OW ER/LESSEE:
CONTRACTOR:
Nam ti" L r/
Name: �' 64-,0 ' oe. 1'
Add r' ss: I0 S 4E C,2 7� C
Company: dos to y of �� �n '`
City: o r� i9l •� Laic/ State:
Addres�s:3qS�'' 7$ 7� ��
Zip- ode', 4,S'Z Fax:
City: /7 �Ht �L State• C
P-ho 'I No.
Zip Code: 3�f�l a Fax:
E-M' il: _.._.,_-_....:__...-._.._ _,.-_. -. ___...-_._ __
Phone No. �--2_a_s�� _ _ _ - _ - _
Fill i fee simple Title Holder on next page (if different
E-Mail:
State or County license: M C 0---,3 5'G%
fro the Owner listed above)
If va
a of construction is $2500 or more, a RECORDED Notice of Commencement is required.
.SUPPLEMENTAL
IN
CONSTRUCTION LIEN.LAW INFORMATION:
DESIG
ER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
N-ame:.l
Name:.
Addre
Address:
City:
Zip:
State:
Zip: Phone:
State:'_City:
l Phone
FEE SI PLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name: `
Addre 's:
Address:
City:
City:
Zip: I -Phone:
Zip: Phone:
OWNEq.V CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify j�at no work or installation has commenced prior to the issuance of a permit.
St. Lucie lounty makes no representation that is granting a permit will authorize the permit holder to build the,subject structure
which is i conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structur Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consid ' ration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in actor Ince with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The folioing building permit applications are exempt from undergoing a full concurrency review: room additions,
acces"so structures; swimming pools; fences, walls, signs, screen rooms and accessory uses to another -non-residential use
WARN . G_ TO OWNER:. Your #ailure.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 ' st inspection. If you intend to obtain financing, co1nsult^with lender or an attorne fore
rnm ring rnTl[ nr�drr>trrhna VLl17f' I�AtI(P Of i'AmmencemenV / �l /1
Signat
Owner/ essee/ ontractor as Agent for Owner
ignature of ractor/License Aolder
STAT
OF FLORIDA �
7A,-
COU
TY OF sic/
OU TMFOFFLORIDA_
The forgoing
instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this
day of , 20_- by
this day of . 20_ by
e,, s
Name of person mg statement
Name of person makin�tement
Perso'
ally Known �R Produced Identification
Personally Known J- -R Produced Identification
Type
.' f Identification
Type of Identification
Prod
red
Produced
(Sign
'lure of Notary Publi - a
(Signature of Notary
RICKY CARL COCHRAN
""" RICKY CARL COCHRAN
,,.•'�i�Y �a '•
`:
Com ,,,,,
�;;`Y • State of Florida
ission No.,.-.-.__--. _ _. �,'_: Notary(W
: ? Notary Publf of Florida
Commission No........_._ .:_. •.. • -= Commissi��t72136
. ; Commission # GG 172136
My Comm. Expires Apr 26, 2022
.
`•,� oY My Comm. Expires Apr 26, 2U22
;46 , ,,rs
Bonded through Nat oral Notary Assn.
�� r„'` Bonded through National NolaryAssrt
RE
EWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE'
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DAT
-REC
VED-
DAT
COMPLETED
Rev.