HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI APPLICABLE INFO 11 UST BE COMPLETrOR APPLICATION TO BE ACCEPTED 1
ate: 3 Permit Number: �+d1ago y
1. ,. BY RECEIVED
Building Permit Application
AUG 0 3 2018
Planning and Develops ent Services ST. Lucie County, Permlttln�
Building and Code Reg' lation Division -
2300 Virginia Avenue, ort Pierce FL 34982
Phone: (772) 462-15 3. Fax: (772) 462-1578 Commercial Residential
I
PERMITAPPLIC 'TION FOR:
PRQPOSED INPRQVEIUTON ' LC�ICA 1110,
ddress:j T Ski (r_ e c
r
egal Description: r( L1 ( -232,5
rooertvlTax
ID #: 1 - P�S - �f�75 - 000 -7 Lot No. 75
ite PlanIName:
i
Project Name: _
Setback's Froi
Back: • Right Side:
;v, l Ke4k
Left Side:
Block No.
Additional work to I performed under this permit -check all that apply:
I
echanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator roof Pitch
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Total Sq. Ft of Cons uction: �' All 9 Sq. Ft. of First Floor:
Cost ofIConstructio $ 7bao Utilities: -Sewer —.Septic Building Height:
O NI?R/LE=SAS
CO 'iRA R:
Name
� :(� •:.,-�..li►'�ct,.;�'�,•
N ame` is
Addr
i Vdi-1
CbnI
e,n, 2 ` s.«.` Stater
Address: `:35�7Kte�i�
City: I'
Zip Code: Q,
4 ."Fax:" ,
City: F~ Joj crc e State: Gt
PhonIe No.
,
Zip Code:. 3Y941• Fax:
_
E-Mail:
Phone No✓ 772 2-:?5'U
Fill in fee simple
Holder on next* page ( if different.
E-Mail
State or County License CC[? 13 2- .2 0
llitle
from the Owner
sted above) ,: .
If value of construction is 2500 or more, a RECORDED Notice of Commencement is 04uired.
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER
Name:
Address:
City:
Zip: Phone:_
Not Applicable
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 iinstallation 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 th;e 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,
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 work,or recording your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF �5'���J��
The forgoing instrurnent was acknowledged before me
thi& day of Al"VO— 20 t-Pby
(Nam person acknowledging )
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification
Produced 40 Notary PuNcStateofFlodda
Sophia Hams
Commission No. MY f om= GG 238873
Expires 020
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF .5 — A6y&i e_
The forgoing instrumggnt was acknowledge efore me
this day of by
(Nam' of person acknowledging)
(Signature of Notary Public- State of Florida,)
Personally Known OR Produced Identification
Type of Identification .
Produced
dN �1otaubhc
Commission No. in m.►ris �3 °
MY Cammmion GG
a w E)Vrft 05rdW, 20 238873
REVIEWS
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ZONING
SUPERVISOR
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VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
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REVIEW
DATE
RECEIVED
DATE
COMPLETED
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