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Home My WebLink AboutBUILDING PERMIT APPLICATIONALL APPLICABLE INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTEDIQ Jq Ir O Date: Permit Number: SCANY E® RECEIVED o� Buil&Q kelrmit Application AUG 0 3 2018 Planning and Development Services ST. Lucie Country, permitting Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential I)ERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line ROPOSED.'IIUIPROVEIVIENT LOCAT10'N.o4`' AIRAWWWANUTIMI Description: � l _ {r)Q/i(/3� (&C C(9_ , 17101 9 — / Cam/' "'qS.s !/ 1 ierty Tax ID #: Ll �Ia a0D'- F Lot No. 8 Plan Name: Block No. ect Name: Jacks Front Back: Right Side: Left Side: �ET '!LED, DESCRIPTION OF WORK b s repJ , - and /00/ UNSTRU.CTI'C7N 1NFORMATIO-N C � 5 itonal wor to be nertormedunder this permit —check all app y: E1HVAC L_J Gas Tank F]Gas Piping _ Shutters ❑ Windows/Doors `Electric Plumbing Sprinklers Generator a Roof Roof pitch Total Sq. Ft of Construction: 16-49 0 Sq. Ft. of First Floor: 9 0--S& vnde K0-1►� It of Construction: $ 4%090,, de) Utilities: [:]Sewer[]SepticBuilding Height: ESSEE WNER/Lvu w, ., . x. CONTRACTOR " ,.M Ni A C 4 P E Fi fr me @ >' Name: -Robe dress:TAl W F2 4-17Y22n b Company: P_'- Ida/f Address: ;j�gy f,1rJ !E&;&S& %'6/X / City: 6, bkYf- State: Zip Code: --54/q4 Fax: YL Phone No. 41f, E-Mail: / o%/ e adecdaAri �QM y: State: p Cod e:./��/ —Z G%� Fax: one No. f��r�—` 9��_ D �� Mail: �G7L� �l�({'� D�( _©/y% I in fee simple Title Holder on next page (if different m the Owner listed above) State or County License: _ _ GLf /W 00c:;2_ If y alue of construction is $2500 or more, a RECORDED Notice of Commencement is required. i �4 b � � °R PK EMrENTA ONSTRIA""" N'L+IEN LAW -INFORMATION` ' � , ,. DESIGNER/ENGINEER: Not Applicable I � MORTGAGE COMPANY: � Not Applicable able Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: WNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. certify that no work or installation has commenced prior to the issuance of a permit. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure hich is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such ructure. Please consult with your Home Pwners Association and review your deed for any restrictions which may apply. I consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work i accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. e following building permit applications are exempt from undergoing a full concurrency review: room additions, cessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use ARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for i provements to your property. A Notice of Commencement must be recorded and posted on the jobsite iefore the first inspection. If you intend to obtain financing, consult with lender or an attorney before mmencin work or recording our Notice of Commencement. �ignature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder CTATE OF FLORIDA , - OUNTY OF Ma I� STATE OF FLORIDA COUNTY OF k rt(y) l IN he forgoing instr ent was acknowledged.,before me his aday of 20 by The forggjng instrument was acknowledged before me this- day of 20l by Kpbelri�, o Name of person making statement Name of persopn making statement ersonally Known _�� OR Produced Identification Personally Known OC OR Produced Identification ype of Identification Type of Identification rode Produced Az_ (Signature of Notary Public- ature of Notary Publi - y MARK MELVIN 6mmission No. '? 'It (W&MMISSION#GG1 'irs+�?o'''•. ��ISSK MELVIN N o ission No. MY EXPIRES: December 17, 20 ION # 1135864 1 =m, P;o�: EXPIRES: December 17, 2021 Bonded TTw Notary Pubrtc tern '• f 9F (° • Bonded Thru Notary Public Undemrite REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW ATE ECEIVED iATE OMPLETED Re .8/2/17