HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll A I PLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Da 'e: Permit Numb
SCANNED
By V61VED
-St. Lucie COSt'
AUG 3 12.018
Building Permit Appli ation Permitting PIa' ping and Development Services Department
eullding and Code Regulation Division St. Lucie county, FL
23 0 Virginia Avenue, Fort Pierce FL 34982
Phi ne: (772) 462-1553' Fax: (772) 462-1578 Commercial Residential
PE
�RIVIIT APPLICATION FOR:
p'RO 0 M,IR INPRaVE(UIEN Lt7CATIC .
Add
ess: _D 6. C, `�
Leg
i l Description:
Pr1rty
Sit4Plan
Pro
Se
Tax ID #: 31�% `9 Lot No.
Name: Block No.
ac t Name:
i
a cks Front Back: Right.Side: Left Side:
T IE.ED Df=�S�RFPT(aN (JI= WQ K;
C�oustRUCTION INFCt A 1t7N:
To, I'aI
Cot
itiona worK to ne perTormed under t is permit — c ec a tat apply:
Mechanical ',Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electr oi, ;+; t;i�r'ai1 P.lumbi'r1g _ Sprinklers _Generator...:., l/Roof Pitch
:, ; . �n `
Sq. Ft of Construction: - h Sq. Ft. of First Floor
of Cc: nI uctioh': $'?''!:_ -_(_' _ Utilities: _ Sewer _ Septic Building Height:
OW14
ER%L -57SEE
WON IT]
Name:
Company: A `a Np 'on 22
Address: A L�
.ip
jll
f
�i
me Chi ( nMe
ddress: (0 3 Ll CJ
1/
ty: � State:
ode: r�Ll (79.7i Fax:
one No. 2,,0 37
/Z
City: (�;,es G� State:
Zip Code: J�(� Fax:
Phone No 7c5 —
E-Mail dn&32s Coiry vA . L
State or County License CC C 13 Z 7 Z?=!�:
Mail:
in fee simple Title Holder on next page ( if different
om the Owner listed above)
If lalue
of construction is 2500.or more, a RECORDED Notice of Commencement is required.
o� ���� L!;
IN�o�nn�
�aN:
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:'-
Not Applicable
Name:
A
.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: V
I II.
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: 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 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
WARNIN T OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improt�i
a to your property. A Notice of Commencement must b recorded and posted on the jobsite
before f st inspection f you intend t obtain financing, consult ith lender or an attorney before•'
Comm work or rec r in our No ce of Commencement.
caner/ Lesi2yR6ntractor
as gent for Owner
Sign f Contractor/Lic se Holder
STATE OF FLO IDA
b
Gn
STATE OF FLO A III
�
COUNTY OF
.
COUNTY OF_
The forgoing instrument w s
cknowled ed before me _
The forgoing instr men was acknowledged before me
this � day of
20� by
this � day of 20a by
Iv`
(Name of person acknowledging )
`
(Name o person acknowl ig.) � M. Garwood
a
on # 9G175422
m Garwood
-+�
= um 16, 2022
' 75422
•,
(Signature of NotaryPu/b
e o on a
(Signature of Notary �������„`� to gjrWLqt ron Way l
Personally Knowny OR
Produced Identification
Personally Known OR Produced Identification
Type'of Identification
Type of Identification
Produced Ih no e
Produced If D 00 (f,
Commission Nd.
(Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW-
REVIEW •
REVIEW
REVIEW
DATE
RECEIVED
.
DATE
q10
COMPLETED
Rev.7/2014