HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE
Date: q ' `b - r L1
Planni''�g and Devel
Building and Code 1
2300 ��J' ginia Aveni
Phol l�(772) 462
Fort Pierce FL 34982
53 Fax: (772)
MON FOR-1
FOR APPLICATION TO BE ACCEPTED
Permit Number:
O�;ANNEDBY - RECEIVED
G99
Building Permit Application Aug 10 2018
g pp ST. Ll le county, Permitting
mercPl Residia
Addi Jscription:
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Propert Tax lD #: -690 2-G,n ` 0A0 °700rp D Lot No. e'Z
Site Plat] Name: ^ 7ucQ i��-L. 61-r; CR Block No. 9 6
Project Jame: 4-f}s40!
Setbac Its Front Back: Right Side: Left Side:
ut.e
wedls 4 b1oG1� ww116
>cn-'O; at /�Iu ws a v< 1 �ac� Cs lt>r�fn �1 �tJ
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Addition
al work to be performed under tnis permit- cnecK all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters V Windows/Doors
Ell ectric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sc Ft of Construction: 360 ICT Sq. Ft. of First Floor:
Cost of (Construction: $ ' RO-0 , oz) Utilities: —Sewer —Septic Building Height:
aiMP�k
WS
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Name1,SL)d,
Addre
h l;-�
Name..M-I'd c-d ;: f7 ► ram 3 �o
s: 5 01) . ec s+
Company: 'b PF-il`a4� eyS f',nNS l�-
- o d- F re7;L StaterL
Fax:
Address: ?3 $ �f:o ` ' L:JYG� eS c�Y+'� �i' ✓� `i Yta,'�
city: ` ` State: lot -
City:
ZipCode:
Phone
No. 1 o 6 `L
Zip Code: 3 Liti V 5— — Fax: 772- 465- 71d73
14W_
E-Mail:
Phone No '772- 26j _779_1
Fill in flee
II
simple Title Holder on next page ( if different
E-Mail � f �ru n C0r-6,ill C (P ctbL, C'avr
from t1
a Owner listed above)
State or County License
11 If value bf construction is 2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable
Name:: vk,i j
MORTGAGE COMPANY: _ Not Applicable
-Name;
Address:
City: �� State:
Zip: Phone:
I,'
Address: I ) Ld,7- dL; rB6�
City: Il-C jJF^{� � State: i --
Zip: 3-1 g V_ Phone '772 17D 9Qk?
l l
I
FEE SIMPLE TITLE HOLDER: Not,Applicable
Name:
Address:
City.
Zip: ' Wl orie: J f ,
BONDING COMPANY:6�=tia__Not Applicable
Name:
Address:
Cit-VII
Zip: `'` ? Phone:
}
OWNER/ CONTRACTOR AfFIDVIlf: Application is hereby m@dle tq,, tain ga.permit:to-do the.work.and'installation as indicated.
I certify that no work or installation has commenced prior to the issuance ova permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the 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 j
commencing work or recordjng your Notice of Commencement.
A)
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signa ure of Contractor/Li
rise Holder
A • STATE OF FLORID
STATE OF FLORIDA
E .
COUNTY OFL
COUNTY OF
The for oing instrt\ ent was acknowledged before me
The fo going inst merit was acknowledge before me
this day of 20 by
this day of
20� by
1_
Milo, II��PI �Li�(f1flC',f?�CQ
b
Name of person making statement.
Name of person making staternkAl.
Personally Known OR Produced Identification
Personally Known ✓
OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
Ak
(Sign ture of Nota
(Signature of Notary P 11 o
Commission No.
,, KARE S. NI ELSEN
_= osstate of FI Si�lst otary Public
_
'9
Commission No. '-.�
Coe0 F rq,;,NjIELS'
Q: Ij otary
�. mmi,
<c ommiss on # GG 207484
'�OF FLOP\O\` MY Commission Expires.
""""� My Cornmissi GG 20;,
JUna Expire
p��b�ic
g
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REVIEWS
FRONT
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
i I
MA
ZONING
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
i
DATE
COMPLETED
Rev. 8/2/17