HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL AF
Date:
INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
%- SCANNED Permit Number:
Building Permit Application
AUG 4 6 2918
Planning al 'd Development Services
Permitting Depertrnen
Building an,' Code Regulation Division
2300 Virgin "a Avenue, Fort Pierce FL 34982 St. Lucie, 0 U n t�, FL
Phone: (77�) 462-1553 Fax: (772) 462-1578 Commercial Re
PERMIT P�PPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSE,,,
IMPROVEMENT LOCATION:
Address: _ L�� � � ,Sp�l q b L L S-Tr) -TE . S'�` L2(4 f. ��l c.,
Legal Descr4ion: yLa Jfp- 100 e. — +e- 5 -4) 1 a-n o ,y vie- f o S7 eDr 4o.4 I
�roperty Tax
'iD #: 3 y Z(p- 703 _ DID i 000 - 3 Lot No.
Site Plan Na ��e: Block No.
Project Nam
(Setbacks F �ont Back: 7. J Right Side: / Left Side:
DETAILED,bESCRIPTION OF WORK:
Eui idlb veto o;ngle- -rom;/y RPsi EeiCe 5 ge iUn-7 Car
Ci a vaq e'�
CONSTRU6, 10N INFORMATION:.
Addit- nal w k to be�jertormed under tnis permit— cneck all apply:
FElectric
VACLJ sTank ❑Gas Piping Shutters ❑Windows/Doors
_ Plumbing Sprinklers E]Generator � Roof Roof pitch
Total Sq. Ft of II'lonstruction:O J-9/ 7 + . Ft. of First Floor:
C st of Constru'Iction: $ �6 t 0,6 _ polities. — Sewer F- Septic Building Height:
I I'I
OiWNER/LEtS,EE: T'CONTRACTOR:
Na'me-FuVelln U e')
Address: 5-{ C!5- ST
cit : -Po�-4 l u U State: �
Zip Code: II� Fax:
Phi ne No.
E-Mail:
Filli in fee simpl Title Holder on next page ( if different
from he Owne listed above)
Name: `mu k o
Company: `SG a rid Sons i &7_,
Addresses: rt �� �1 Z � 7
City: lc�cie State: —
Zip Code:� Fax:
Phone No. 9) 0q1- 35q >
E-Mail: (f,6 rme rJ C Gl hoo. C p /'?
State or County License: (Q �—
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required,
5Q'1 Purr
SUPPLE
ENTAL CONSTRUCTION. LIEN LAW INFORMATION
DESIGNER/ENGINEER:
Name:
Address: I'
City: A
Zip:
I _Not Applicable
au) oJe, -A Inc.
MORTGAGE COMPANY: _ Not Applicable
Name:
IS y SW
Address:
State: t�2e—
Phon a 3
City: State:
Zip: Phone:
FEE SIMP'l
Name:
Address:'
City: i
Zip: III
E TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Address:
I
City:
Phone:
Zip: Phone:
OWNER/ NTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that o work or installation has commenced prior to the issuance of a permit.
1
St. Lucie Cou ty makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in c flict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. PI' se consult with your Home Owners Association and review your deed for any restrictions which may apply.
In considera on 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, I building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory str ctures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING O OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvers ; nts to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the: lr inspection. If you intend to obtain financing, consult with lender or an attorney before
commenci fork or recording; vour Notice of Commencement.
ner/ Lessee/Contractor as Agent for Owner ,gfgnature of Contractor/License Holder
STATE O1 FLORI[#y STATE OF FLORID
COUNTY F �7 - Sri c_r COUNTY OF tub
The forgoi `instru ent was acknowledged before me The forgoing instru was acknowledged before me
this z i d, ! y of 201d by this `2-r day of 20t, by
N 'me of per
Person ally' Known 1
Type of Identification
Produced 1
Commissi
@king statement Name of perso,p,rfiaking statement
OR Produced Identification Personally Known OR Produced Identification
Type of Identification
Produced_ _ .aultittiitn._
raryll blic- State of
\��t�11N1IIIUI///r C RbI,��
HERNgiV�/i4i 7 a
lnridz��° l 19,? • �• (Signl � i f tar-0 .. blic- State o I r N
*.(Seal) * Commission No. '3 (C 2 G083815
2 : #GG 093615 O9'>' � %?;o°�aed tht� M�;`�'• Q A � r!c e �'
_��•��d.,_Ba. .c0 a0`y O�� �/9. (ie� b Und;.%G® 74
REVIEWS!
FRONT
ZONINii��el
C$�`��.�1Tt
PLANS
VEGETATION
SEA TURTLE
/iVt�PU�ROVE
COUNTER
REVIEW //
1111(R1ltmAtW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED,!
DATE
CONIPLET
D
J
Rev: 8/2/17I