HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONkil APPLI
Date:
INFO MUST BE COMPLE'rw FOR APPLICATION TO BE ACCEPTED
Wx- 0 1 ai'D
® — Permit Number:
SCANNED
�I♦w BY
tr
I-R. Lucie COO*RECEIVED
Building Permit Applicati n AUG 0 6 2018
Planning and' Development Services ST Lucie County, f+ermittin
Building an Code Regulation Division
2300 Virgini Avenue, Fort Pierce FL 34982.
Phone: (77 ).462-1553 Fax: (772) 462-1578 Commercial Residential _
PERMIT
PPLICATION FOR:
J.PtRa��J'md1NPRC1
`IVIN'�Lt. I �'
dress:
dal Description:
roperty Tax I D #: l M.-M. C I Z Z. w i 1'
ite Plan Na e:
roject Nam
setbacks rout Back: Right Side:_
Y
Left Side:
rt
� L
Lot No.
Block No.
(Aciaitionaiw, rk to be pertormeci under tnis permit— cnecK an tnat appiy:
_Mecha ical _ Gas Tank _ Gas Piping _Shutters _ Windows/Doors
_ Electri _Plumbing _Sprinklers _Generator jZRoof P9 c
ota_IkSq Ft fiCon'structiori: d ' Sq. Ft. of First Floor:
ostuo`f`Cons 'r"ucton$ �lfQ�, Utilities: Sewer Septic Building Height:
Name 'Name:
Address: ; U0 14 VLOI Company: t . -
City: Vc le State: Address:
Zip Code: 3 Fax: City: State -
Phone No. Zip Code: Fax:
E-Mail LAPhone No
Fill in fee sirple Title Holder on next page if different E-Mail
from the OW lner listed above) State or County License
value of cootruction is 2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable
Name:_
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:.
Address:
City:
Zip: Phone:_
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
_ Not Applicable
Not Applicable
UWNEK/ GUNI KAGTUR AFFI VVIT: 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.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subjectlstructure
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-residenti a I use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twi!e 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 be ore
commencing work or recording your Notice of Commencement. �11
oe
Owner/ Lessee/Co Agent for Owner
Signature Contractor/License Holder
Si ture of ractor as
of
I
STATE OF FLORIDkt
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instr ment was ackpowledgeg before me
The forgoing instrument was acknowledged before line
this day of 41 20_IL by
this day of 20_ by .
i
(Name of pers n acknowledging)
(Name of person acknowledging)
J.
(SignAu ,e of Notary Pub ic- ltate of Florida)
(Signature of Notary Public- State of Florida )
Personally Known ro 4A ILd nElfiblWnSED ..
/°a�,
Personally Known OR Produced Identification
. moo'`'"
�` r°�''
Type of Identifi n State of Florida -Notary
# GG 207484
Type of Identification
Produced Commission
produced
om.... 2022P .
IVIY June 12,
'
-'Commission' No.
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.7/2014 -