HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:l Permit Number:
-, -- _ - RECEIVER
Building Permit Application I OCT 0 5 2018
Plann{ng and Development Services I ST. Lucle County® Permltting
Building and Code Regulation. Division -
2300 irginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential —ci.,—
PERMIT APPLICATION FOR: Roof c� %
-PROPOSED IMPROV;EIVENI"kLQCATI0N7... k ° ,5�_ '\�, :.>.r. ��.'' l'r1,J f y.
Address: 50n_ DPp no 3\yim YL
Legal Qescription: � -L OC �Q�t,n C_)Cj(6 5 2±9=
Property Tax ID #: 2H0S- ? - UZ9 — ugym- Lot No.
Site PZ Name: Block No.
Projeci Name:
Setbacks Front Back: Right Side: Left Side:
'N;'t rrj �Icj ri')o� zn'j ' &'-Y, A-0 �WOLa max. glace.
�� cow
-
MEN"'.r 7.sn.�,6.�^a:•,,✓.
Haaltlonal worK to be errormea under tnls permit — cnecK all apply:
�HVAC 11 Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors
Electric F� Plumbing Sprinklers E Generator 0 Roof Roof pitch
Total Sq. Ft of Construction: +Q�� S . Ft. of First Floor: CR (-)
Cost of Construction: $ 01 Utilities: Sewer Septic Building Height:
OU1/N�f�. _ s
. am ..m a
_wt%[7rt
Name
;
Name: at c [(cl NJ CiDe ,
Address:
lZ-��Q y4 �'g-
Company: L_ oy- 2,-1 , rg \ -���' 1 A �bf.5
�A 17ie.{CQ. State:
City:
Address: (ol(-)I
Zip C
Phone
E-Majl:
de: _3Lig Fax:
No. a�� -,� g
City: EA . t ') �P_rP2 State: 1`-L
Zip Code: Fax:
Phone No.
fee simple Title Holder on next page (if different
E-Mail:
Fill in
from the
Owner listed above)
State or County License:
it value of construction is $Z500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUC?TION LIEN LAUU INF,ORMATIO,N
., Oj
`
.
DESIGNER/ENGINEER:
e
_ Not Applicably
MORTGAGE COMPANY:
Not Applicable
Name
Name:
Address:
Address:
City: i
State:
City:
State:
Zip: I Phone:
I
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Phone:
I
Zip: Phone:
Zip:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which i9 in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structu Ie. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
comm'encing work or recording vour Notice of Commencement.
Y/l/" Y S
as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFLA X� e- COUNTY OF , i.icC e_
The for oing instrument was acknowledged before me
this day of QrAZ6er , 20 3$by
ame of person acknowledging
ry Publics State of Florida ) '
Personally Known �_ OR Produced Identification
Type of Identification Produced
The forgoing instrument was acknowledged before me
this 5 day of CC+D%r 20 j& by
R kd(- A V - l^_di4�
(Name of person acknowledging)
I %,I,,
n, I
(Signature otary Pu lic- State of Florida )
Personally Known �jt_ OR Produced Identification
Type of Identification Produced
ion No - Commission No.
'%'A M�.�, ,y SALLY
PORTES
i�.o Commission # GG 47625
:?�O�` November 15,
07/15/2014 2020_
SALLY PORTES
Commission 8 GG 47625
My om
November 15, 2020
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVI W
REVIEW
REVIEW
REVIEW
DATE I
/ a
COMPLETE
,S
INITIA LIS