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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL�APPLICABLE INF ,MU T BE COMPLETED FORAPPLICATION TO•BE ACCEPTED i Date: { . 45. I(� Permit Number: V" �O of RECEIVED -- Building Permit Application SEP 0 5 2018 Pl I nning'and'DevelopmentServices Building and Code Regulation Division v�� 1) ST. Lucie County, Permitting 2360 Virginia Avenue, FortPierce FL 34982 Phone: (772) 462-1553 Fax: (772)-462-1578 Commercial Cie CRGes�iatential._ PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line ass: W 9!r3 0 l0 Sou-ThW f N ® -17ZA i L-- r-7- PI -C<_ --F`- Description: "sL1 '0tt�--A i2-ruzlednd, 'VO Ea-S'7— 34 ,S-6C-T/ v rty Tax ID-#. ,� a'7 3 - 003 � �- ©QQ - Lot No. Plan Name: Name: (s Front 110 ' q l,Back: 103,�� Right Side: 3 9 "'16'Left Side: LI f 1-7 Block No. Total Sq. Ft of Construction: �r eilities: . Ft. of First Floor Cost of Construction: . E l! _Sewer Septic Building Height: 4.va d -r "" 1 fin.� O11U E LESSEE cr,.t "m p"''yt` CONfftRACTOR "t ? , tt*±� n.4d.b."cia2rt�'�a�.ak�'a�iz4xz.,'?J»z Name Zf ,6 a jU act& 26 /� �1'� Name: Z2/ e. 4a .i,/1. Address: 75 /gel) f Glee/L 02 Company: ,�G/n Can5�GwLT/y /J City: Gi' e, State:..GL Address: Syz- N&.1 City: PsL State: �2 Zip Code: ,3Vg/L/r7 Fax: --- Phone No. ��� "�-72— — %O&S- rr Zip Code: 9<P(o Fax: E-Mail: (�etsra')G'luy/S�np.n/,,;C,QA Phone No. 6'&/r�— 1ill'in fee simple Title Holder on next page ( if different E-Mail: DCq-�5 #% � 1 rn CD,r)5 -f'-U [�in nr. ol m. State or County License: C 6G O ZOC�d' ° cov from the Owner listed above) I If value of construction is.$2500 or more, a RECORDED Notice of Commencement is required. I ' DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: '56 m n+ rl o f Sf & N Name: 5e4 C o a s T 802t:�/L Adldress:'72S' �f,lOsL- 81,v Q �- z03- Address:. /7 20 -A k/ fog f �.� �31"d .4 City: ids (__ State: -Ft. City: p s t- State: -,C�L_ Zip: Phone 717,- Z96-yS17z- Zip: Phone: I FEE SIMPLE TITLE HOLDER: )f Not Applicable BONDING COMPANY: of Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: DWNER/ 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. A. Lcie 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 ctrulcture. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. n consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work n accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. rhelfollowing 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 MAI RNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for mprovements to your property. A Notice of Commencement must be recorded and posted on the jobsite )efore the first inspection. If you intend to obtain financing, consult with lender or an attorney before -nmmanrina Wnrk nr rprnrrlina xim it Nntirp of Cnmmanramant. Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of ont actor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF ST I U �:(�= The forgoing Instrp1,K�nnen-t was ac nowled before me t�ls j& day of Y-�[lrl (.f S , 20&by The fprgoing instrument was acknowledged before me this 1lD day of 20_1.t by Name of person making statement Name of person king statement Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced L%JL Produced LYNNFMERONE .... LYNN M JiPKYP y'/, ((Sig a re of Notary Public- t� o ida rotary Public - State f Rl;ag e rNollary Public- State 1 i >��._•Commission Commission # GG 010657 Q'.3, No.CC G U ' +. a.°�SdMt)Comm. Expires Jul M Comm. ExpirCommission 2;oi9P,1i 60io(�n �'•;;�oF �� y ,. . Bonded Ihrough National N I i lary Assn. Bowed through Nat REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE (RECEIVED IDATE COMPLETED Rev. 8/2/17 t of Floridl3 010657' s ul 12. 2020 In Notary Assn