HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:BY
Caa
nt RECEIVED
EMAIng Oermit Application AUK'0.2 2018
Planning and Development Services
Building and Code Regulation Division PerSt. Lud Department
St. Lucie Cou
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED": PRO VEMENT-LOCATION:;
Address: i_ ►!f Cv'v�evJ Or M Ise-n 6ecu_k F L 3y9 5.7
Legal Description: -roP L)p WNGON W 2 0. V7 �T l>F LO'V r7, ALL 'LLIV
CTS ON S 2 S Fr OF Lo'k 3 Cif( �
Property Tax'ID #: LA 504 40 01 _ 0 01-2 00 0 3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF.INORK
i l= L 16 7 1-7 ✓�
p
CONSTRUCTION INFORMATION
Additional work o be nerformed under this permit — check all t= apply:
EIHVAC Gas Tank ❑Gas Piping _ Shutters Windows/Doors
EI—Electric 0 Plumbing Sprinklers 11 Generator Roof Roof pitch
Total Sq. Ft of Construction: h 0 8 S . Ft: of First.Floor:
Cost of Construction: $ � 6 0 o Utilities:[ Sewer. [-] Septic Building Height:
J-OWNER/LESS`EE:. _
CONTRACTOR
Name 10.sS 3Cu ob-%oV)
Name: uv "
eN Ke,, m
Address: 107- im-V'&
Company: PNAC7 4'
- vo,
City: en%tn �f,c" State: `L-
Address: C2G SW
' - CA
Zip Code: 31-19S Fax:
City: �C r, _Sn,,Ak- LuL,' C State: VL
Phone No. 97 Z — 97 b - U i i
Zip Code: 3H 015 3
Fax:
E-Mail:
Phone No. �Z-jtiu -V �1
Fill in fee simple Title Holder on next page ( if different
E-Mail:
from the Owner listed above)
State or County License:
S C.0 O b
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW.I,NFORMATION:
DESIGNER/ENGINEER: — Not Ap
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: — Not Applicable
Name:
Address:
City:
Zip: Phone:
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 ao the worK aria mstdndLw11 db IIIIJI .dL0u.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
structure. Please consult with your Home Owners Association andrreview your deed for any restrictions which may apply prohibit such
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 fist inspection, If you inten' } o obtain financing, consult sult w� lender or an attorneybefore
�
commeni;hhgjwuiKui 1 cwi ui
ignature of Owner/ L ssee/Contractor as Age for Owner
Signature of ontractor/Li nse Holder
�
F FL
COUNTSTATE OY OFORIDAS
OUNTY OFORIDA
The forgoing inst ent was acknowledged before me
The fo going instr nt was acknowledge before me
May 20 by
thisry ay of 20 Il by
this of \
0
Name of person making statement
Name of person ma ing statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(' tur of Notary Public- State o Florida)
(Sig a of Notary Public- State o Flo a)
Commission No. �����,,,, (S?al:)HAHNA INGRAM
LASH!'�.��pIVGRAM
Commission No. ��� �. (Seal)ate of Florida
`•=op°�-; Notary Public - State of Florida
•`o�P-; Notary Pubuc 018 .
;a ¢ Comm. Expires Dec 20, 2 ,
w ; • My Comm. Expires oec 20, 201
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PLANS VEGET 10 —TURTLE'---MANGROVE
REVIEWS FROM,=;SU.PERVISOR
COUN E REVIEW REVIEW
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DATE
RECEIVED
DATE
COMPLETED
. 8/2/17