HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 j
Date: 1() '3 • 11 Permit Number: `� 1
RECEIVED
Building Permit Aplicaion OCT 0 3 2018
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Planning and Development Services a�
Building and Code Regulation Division a ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982 01 Lude Munn'
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address:
Legal Description: \&1 JbL)\L4-e, b1A 6
Property Tax ID #: 24DE 603 _to &—(— =7' 6 Lot No.II
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
Block No.
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itiona work to be pertormeaunder this permit —check T
apply:
HVAC �J Gas Tank []Gas Piping _ Shutters F]Windows/Doors
Electric Plumbing Sprinklers El Generator Roof Roof pitch
Total Sq. Ft of Construction: G/ ,0_0 S�Ftj of First Floor:
Cost of Construction: $ •OO Utilities: I_J Sewer __ _ Septic Building Height:
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Name —o
Address:7_1S 9N�'`
City: is C T)_i P,CG State:
Zip Code: 3(AA f Fax:
Phone No.177, —14 (,7—V(- A �
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Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Col
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DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: 1 4
Name:
Address:
1
Address:
City:
State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
I 1
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
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 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 -an the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
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Signature o Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORID
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrument Was acknowledged before me
The forgoing instrume t as acknowledged before me
this jnS day of [ 204 by
this fl3 day of 20101 by
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification ��
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
Kimberlyn M. Garwood
(Signatu
(Signature of Notary Public- State of Florida )
�i��.���' Bonded thru Aaron Near
I)
Commissiori is a
Commission No. .(Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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tev.8/2/17