HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
I
Date: Permit Number:
Building Permit Application SEP
Plan ning and Development Services ST. Lucie county, Permitting Building and Code Regulation Division ------ ---�
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Building
PROPOSED IMPROVEMENT LOCATION:
Ad d4s � 4181 aor-nensen PA, Fort `P ( rCe . FL-2
=_ ----9 1ntin 11.0 n.:i.: C I1-� i,&K 'li- I In G` 1/r1 r1.C.0
1-Icz)J 1 :. LIB '= - 1 L�rilat- . -f L70 I\i f l V F- 6"-no- laf z>'I ,J
Property TaX_ID-#-_- -3403 - 502 ` NIB B " nJ12—k Lot .No. i SO
Site Plan Name: B�lackNo
Project Name:
q (J I CSetbacks Fron Z% O • ZCac : d i� 'Righ de? Left I eS d :
DETAILED DESCRIPTION OF WORK:
Install enclosed 30x4lx4O detached accessory structure on footers/concrete
**NO ELECTRICITY"NO PLUMBING'
CONSTRUCTION INFORMATION:
Additional work to e nertormed under this permit - c ec a apply:
HVAC Gas Tank ❑Gas Piping Shutters ❑ Windows/Doors
11 Electric 0 Plumbing Sprinklers E Generator W Roof Roof pitch
Total Sq. Ft of Construction: 1200
Cos of Construction: $r4
S Ft. of First Floor: 1200
Utilities:Sewer z Septic Building Height: 12
OWNER/LESSEE:
CONTRACTOR:
Name 184RG MUC4VI-01V
Name: 04MES /0c.$YER
Address: 47$/ J0R4QEN3&4 R 4D
Company: Carports Anywhere
city) Fogr Pic-RcE State: FL.
Address: PO SOX 776
Zip Code: 3+6181 Fax:
city: (3T4P_kE State: FL
Phone No. 772. 370 " 5049
Zip Code: 32091 Fax: (352) 468-1113
' E-Mail:_ l S4A-C M4!(6(2- CI ,911--COM
Phone No. (352) 468-1116
E-Mail: jbpermitsfl@gmail.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License: CBC1251995
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: BECNToL 67r4J n1EC-Rl16 41EST71%
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:6006 tUJFST IVE�K ,4VE/V0E
City: AEL« t40 State: FL
Zip 3212.0 Phone
Address:
City: State:
Zip. Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Address:
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 cer
ltify that no work or installation has commenced prior to the issuance of a permit.
St. L� cie 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 acclordance 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
commencing work or recording vour Notice of Commencement.
f �'z
Signature of wm r/ Lessee Contractor as Agent for Owner
Signatur&df Contractor/License Holder
STATE OF FLORID t -
COUNTY OF A
STATE OF FLORIDA
COUNTY OF $Ir A4:'oy4
�
The r oing inst nt was acknowledgefore me
thi ° ay of 20 by
The foAr.�oing instrumentwas acknowledged before me
this � day`of SP n'r• 2,0 Vb by
Name of person making statement
Name of per on aking st tement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of [den fication
Produced
Produced
n tore of Notary P_ I rida��
Signature o1v Notary Public- State of Florida )
,����`` e, LASFIAHNA INGRAM
Commission No. , o �;'-, �a
Nat hlic -State of Florid
om%*s% , No. SIERRATERRELL (Seal)
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-•. . •� My Comm. Expires Dec 20, 2011
20 •V% -6
Cornnissloo#GG039654
Commission #FF 177249
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�, v� Expires October 18, 2020
tional Notary s ;n.
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Rev. 8/2/17