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CABLE INFO MUST BE COhnriLETED FOR APPLICATION TO BE ACCEPTEr,� � C%
Permit Number: /M `_
CANNED
BY
~� RECEIVED
Building Permit2pplication SEP 0'5 2018
Plan 'mg and Development Services Permitting De
Buil. ' rng and Code Regulation Division St. Lucie Cou tyent
2300f (Virginia Avenue, Fort Pierce FL 34982
Pho Ive: (772) 46271553 Fax: (772) 462-1578 Commercial Residential
PER11�,MIT APPLICATION FOR:
ddre'Is:
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Legal'Ilescription:
Prope y Tax ID #: / v r u v "iv I �S 7yvlJ Lot No._
Site Pl n Name: Block No.
Proiee"11 Name: J
Setbal�ks Front Back: Right Side: Left Side:
7 P �+�vS�n-v►-a(FC) -y` U //C)
�G ✓K' I ► � }., z.�-Cc' 4 d►�� he.�1'S � �� V 'M�"%�'r G Cll .hl
VWb;)h{zlOM16 rJgN.
Additional work to be pertormed under this permit- check all that apply: A /��
_ echanical _ Gas Tank _ Gas Piping _ Shutters/ V Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total S . Ft of Constru n: Sq. Ft. of First Floor:
Cost oil I,Constructi n• 67, Ou-')Utilities: —Sewer _Septic Building Height:
Nam
Address:
City:
Zip C;
Phon
E-Mai
Fill in
from
I ce)" dw I
Name:
Company:
Address:
City: State:
Zip Code: Fax:
Phone No
O
,
IgPr State: -.
de: Fax:
I�LNo. %-72- .9'd 1
/UD jj 1 %
l:
fee simple Title Holder on next page ( if different
he Owner listed above)
E-Mail
State or County License
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If value'0f construction is 2500 or more, a RECORDED Notice of Commencement is required:
SU PLE �� At. GQNSTR+UGTItJN IEN
lN�FO NATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY:
Name:
of Applicablle
Address:
Address:
City: State:
City:
State:
Zip: Ph a
Zip: Phone:
FEE SIMPLE TITLE. HOLDER: _ Not Applicable
BONDING COMPANY:.
_Not.Applicable
Name:
Name:
Address:
Address:
City:
City:
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 A,
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such 1!
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 jobsi�e
before the first inspection. If you intend to obtain finapryze)ng, consult with lender or an attorney before
commencing work or recording vour Notice of Commencement..
.Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTY OF
Theoing instrument was acknowledged before me
fg
The forgoing instrument was acknowledged before me
this day--of``c20 T% by
this day of 20_ by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identificatio` n
Personally Known OR Produced Identification
Type of Identification
Type of Identification �I
Produced
Produced
d(ure
ti
of Notary P�u lic- Sta
of Notary Pu lic- Staof Florida)
(Signature of Notary Public- State of Florida )
5 4NA
Commission No. ,°ot""�P''ei'•4 Pam) INGRAM
Notar T'UGIIC
Commission No. (Seal)
-State of Florida
•e My Comm, Expires Dec 20, 2018
REVIEWS
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PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
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REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 8/2/17
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Page 1 of 1
`orrice ,FiiaeHe
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Enter Permit#: (Press ENTER) 1809.0053 r "--__., d __...,__
(View Scanned Pertnitsl 1809-0053 Email Info For Reviewer Comments
i :PERMITINFORMATION
Permit #: 1809-0053 Job Address: 18005 BELMONT.AVE Parcel
#: 1301-60"123-100/0 s'
Master Permit #: Permit Type: BUILDING RESIDENTIAL RENOVATIO Permit
Status: lPending Job
} GARAGE REDO & NEW EXTERIOR DOORS. HOUSE DOORS & WINDOWS -IMPACTS (4) SOME
i' `i Description: ELECTRICAL, WATER HEATER, DRYWALL GARAGE, KITCHEN'CABINETS, PLUMBING, V Date Issued:
Issued By: Finaled: Finaled By:
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COUNTER COMPLETE ; 9/5/2018 9/5/2018
REVIEW ? INGRAM
9/5/2018
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//code/(S(wrvlfialewsejdl54c5ijfts))/Add EditReview.aspx?Permit Id=276096 10/15/2018