HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLe , f-D FOR APPLICATION TO BE ACCEPTED )
Datel Permit Number: 1 Q 1 0_
RECEIVED
OCT052018
i Building Permit Application Permitting Departm®nt
Plann Ing and Development Services St. Lucle County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982.
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential K
PERMIT APPLICATION FOR:
Address:
Ott Lume L'oM, nl
Legal Diescription:
Prope iyTaxlD#:
Site Plan Name:
Project Name:
Setbac ks Front �� Back: /0, l ( Right Side: i Left Side: 1. �2
'te4 --tof igve
z� lei& K01 IQ X&q ld
Lot No. 7-a
Block No.
�s
Additional worK to be pertormea under tnis permit- cnecK all tnat apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: Cam[ Sq. Ft. of First Floor:
I
Cost of Construction: $ 11�u Utilities: —Sewer —Septic Building Height:
owN�R/1.1:assElr,:
co1uT �oR;
Name
Name:.
/
Address: �c�v�6 2 f"Ar2Cr�e
Company: .1M cn crk.- L,v, ,
Company-
City: i -t- tE�L.C� State:-(
Zip Code: _ yi�� Fax:
Phone No.
Address: L% l L+'- pA1lei D O-
_
City: P�eake-- Stater
Zip Code: 3qJ / Fax:
Phone No -T77-157T [
E-Mail:
Fill i0ee simple Title Holder on next page ( if different , .
from the Owner listed above)
E-Mail �c.�S WIA�c-� c� Cf A4J4-.( .Ccm0-
State or County License _.�0�7
If valuelof construction is 2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENT .t, C M NSTRUCT UN IEN NFORMP►Tlt•1N
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:'
Address:
Address:
City: State:
City: State:
Zip: "• Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: 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. LucieCounty 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 your property. A Notice of. Commencement must be recorded and posted on the jobsite
before t�h�e—first i spection. If you intend to obtain financing, consult with lender or an attorney before
commencln w rk or recordi ur otice of Commencement.
Signu of Owner ntractor '; Agent for Owner
(Lgnaturerof Contras ense r
ATE OF FLORIgD ,, ,
STATE OF FLORIDA
COUNTY OF
COUNTY OF Sk, L .
The forgoing instrWent was acknowledged before me
The forgoing instrument was acknowledg before me
�
this S day of es�^ 20 N4 by
this � day of drab 20 by
v—
y a 6 -%. w+ %cN
(Name of person acknowledging')
(Name of person acknowledg g )
(Signature of Notary Pu lic- State of Florida)
(Signature of Notary Public- State of Florida')
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification.
Produced L.
Produced
GIG j'
�:gv
Commission No. $ �� a RIEG,�cN '.
DEANNAMARIE
Commission No. � w - myCOMWNS
� 0220'
' 'u, 2020
DEANNAM p^2U'-3 . +
'vPu ISSIpN# 20 '�
' *= EXPIRES: Decemoer 1 k
ems^ a. '119"'
:�,�. •o, No�rypubliclJnderv+ �r�
g6,20
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e
�; EXPIRNNo�
PublicUn e
REVIEWS
FR;E°; oZ®
SOR
PLANS
VEGETAT ON
SEA TURTLE
MANGROVE
COU 'AkfQTHT
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
,
DATE
COMPLETED
ev. 7/2014.