HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI
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ALL APPLICABLE INFO MUST- E COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date:. � Permit Number: _-4
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Building Permit Application
Planking and Development Services
SEP 2 2018
Building and Code Regulation Division at'I� s I �"f 1 C� 1 C1 Q_ J � '� � i'� l^j-i � � �
2300IVirginia Avenue, Fort Pierce FL 34982 I
j Pho ie: (772)462-1553 Fax: (772) 462-1578 Commercial R Slab-„ „w �, FL
PER 'MIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: /09 62el /11 �,� OF p � �
ESA A ..nA.�..aa
Legal escription: birf20AITU I/TUA(rC -By-17/6-51 0Abaylq�pom vo-1 uaxr uF 90P eab-k0-,Tq
Propel Ity Tax ID #: q:S1J-Y1Q - bl,RS- OQQ- O • 40t-No- 00
Site Plan Name: Block -No. ,r t
Project Name:
Setbacks Front Back: Right Side: Left Side:
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wo
unaertnis permit -cnecKa
0 � II II
I�VAC u Gas Tank ❑Gas Piping UShutters
lectric El Plumbing lSprinl
Total Sq . Ft of Construction: 13
cost o�'Construction: $ /9.f to Ua
!rs 0 Generator
S Ft. of First Floor: _
Utilities:1]Sewer Septic
QWindows/Doors
Roof = Roof pitch
Building Height:
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Name Itl'lOWn (-a)!Lt--r.,n
Name: —860
Address: BUD A_), 6AIY1S1MOW2 A /w-
Company: eAl2-bM L--RtyF-rn& Q Srbrn6:
Address: Jhb/ 5E 5• J TEMry �L71 0-7:461
City: IR04AL
OAL State: 17K
Zip Code:
y J10 (a Fax:
City: ST L ✓� « StateFL
Phone
Zip Code: 3 (/9sa Fax: -17a-33s n15S,�
E-Mail3
INo.
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Phone No. •'7`n- "')35- 9sS0
Fill in fee
E-Mail: D. I�YIIR,`LP LA�2DE)1AtJVDFTnG, &�
simple Title Holder on next page ( if different
from t!e
Owner listed above)
I
see o l County License: &IC o3a?S/3
I If value bf construction is $2500 or more, a RECORDED Notice of Commencement is required. I
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fSIIPPLEN`IENTi4L CONSTRIJ�TION LIEN> LAUI/ INFORMATION. Y
'�i'-
DESIGNER/ENGINEER:
Not Applicable
MORTGAGE COMPANY:
Not Applicable
Namle:
_
_
Name:
Addi�'ess:
Address:
City:'
State:
City:
State:
Zip I Phone
GI
Zip: Phone:
FEE SIMPLE
TITLEHOLDER:
Not Applicable
BONDING COMPANY:
Not Applicable
Name:
_
Name:
Address:
Address:
City:1f
City:
I
Phone:
Zip: Phone:
Zip: III
IVII
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucien 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
structui''e. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
11
In cons;deration 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 follPwing building permit applications are exempt from undergoing a full concurrency review: room additions,
access ry structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WAR ING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improTiements to your property. A Notice of Commencement must be recorded and posted on the jobsite
beforelthe first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording vour Notice of Commencement.
J.1 ,
Sig fur ner/ -Less e 'Cont ractor as nt or Owner
Signature of Contractor/ 'c nse Holder
STATE OF FLORIDA
STATE OF FLORIDA
COU TY OF 51� L(,z'CT
COUNTY OF C.UCIT46�'
The fo;r omg instrument was acknowledged before me
The forgoing instrument was acknowledged before me
�%
this �iN day of A/!l ELT 20 /F by
this c day of �iGL�fc%5� 20-ZE by
Name of person a ing statement
Name of person making statement
Personally
Type 8f
Known OR Produced Identification
Identification
Personally Known �L OR Produced Identification
Type Identification
of
Produced
Produced
\
1
(Signaldle
of Notary Public- State of Florida)
°SPRY Pug�c DENISE LEMAY
a ••••
(Signature of N ary Public- Stat of Florida )
(tY PUg DENISE LEMAY
• �'
Commission
No. � � r173�%�+ * COMMISSION # GG 0
EXPIRES: March 23.
3�6 �' o-f%/o ••
r° ommission No. 0M ]COMMISSION#GGO
t
a`
w ee EXPIRES; March 23,
'-OF Fl Bonded Thru Budget Notary
��oF ��°�� Bonded Thru Budget Notary
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/,17