HomeMy WebLinkAboutBUILDING PERMIT APPLICATION%PPLICABLE INFO U T BE COMPLETED FOR APPLICATION TO BE ACCEPTED _ Q
e; 1�7 Permit Number:
SCANNeD
F By RECEIVED
Application . St Lucie Ceul�t
BuildingPermit A lication y SW 10 2018
fining and Development Services
ding and Code Regulation Division Permitting Department
D Virginia Avenue, Fort Pierce F134982 St. ucie County
me: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Legal Description: -h/®Z /j � cj 1G(�< 7f 7___ 11�Z U E - G 47
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Pro :i rty Tax ID #:
Site Plan Name:
ProjLt Name:
Setbacks Front Back:
Doz f'/,/j
Right Side: Left Side:
Ul / T/r/ ULC - I/l�C" �
Lot No.
Block No. i
'4`r 14 G#* 6/c �
Additional work to be ertormed under this permit —check all apply:
E1HVAC 13 Gas Tank []Gas Piping _ Shutters Q Windows/Doors
F1.1 Electric 0 Plumbing Sprinklers Generator g Roof Roof pitch
Total Sq. Ft of Construction: �(o t./ S . Ft. of First Floor:
Cost of Construction: $ 67 -7 Utilities:Sewer 0Septic Building Height:
.Id
64
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Address:
City
Zip
Phone
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Name: V /Ij- _ Ui/_
Company: All Florida Weatherproofing
Address: and Construction, Inc.
4231 112th Terrac rth
City: �i�.
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Zip Code: earWaer, 376�
Phone No. z7 7z
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�%rC�, �L� State:.
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No. n l
fee simple Title Holder on next page ( if different
I I the Owner listed above)
E-Mail: Qi 1>4 ( o
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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IGNER/ENGINE R:
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ress: a3 e ti
3 Phone_
SIMPLE TITLE HOLDER:
ie:
ress:
Phone:
Not Auplicabl MORTGAGE COMPANY: V Not Applicable
,r
�C � 7 % "1` Name:
A Address:
e ICity: State:
Zip: Phone:
Not Applicable
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
of Applicable
OW ER/ CONTRACTOR AFFIDVIT: Application is hereby made -to obtain a permit to do the work and installation as indicated.
I ce' iify that no work or installation has commenced prior to the issuance of a permit.
St. L ie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
whic. is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
stru ure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In co 11isideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in ac ordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The ii Ilowing building permit applications are exempt from undergoing a full concurrency review: room additions,
acce sory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WA, NING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
imp,ovements to your property. A Notice of Commencement must be recorded and posted on the jobsite
bef 're the first inspection. If you intend to obtain financing, consult with lender or an attorney before
co mencine work or recording your Notice of Commencement.
Sig ;'ature of Owner/ Lessee/Contr5cfor as Agent for Owner Signature of Contractor/License Hold r
ST E OF FL STATE OF C UNTY OF ORIDA 9511(l LL 14 C COUNTY OF FLORIDA �/ , /� � ��r
Th, `f going instrume t a ,acknowledged efore me The f oing instrum n 's acknowledged before me
thi i day of 20 �LT by this day of �1 20 by
Name of person king statement Name of person aking statement
Pe 'sonally Known �OR Produced Identification Personally Known r7OR Produced Identification
Ty ie of Identification Type of Identification
Pr' educed Produced
(Si' nature o otary u i - o FI ri (Signature of Ill Publi
�r �(i"•. GAX ZUPKO
jis� Pcy=. yypp,lL;;uuPKO /?°,'; Notaryry����kkf�ff State of Florida
Co, mission No. °' • Notary PubA('agtate of Florida Commission No. `_ Coh�filfilbn # GG 229885
Commission # GG 229885 ''•.„oFA My Comm. Expires Jul 4, I022
d'
,oF,.•' My Comm. Expires Jul 4, 2012 Bonded through National Notary Assn.
onded through National Notary A- I
R, VIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
IVED
CO; PLETED
Rev. /2/17