HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONv
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number MO-Dl—l"I
KWE
Building Permit Applications
.16�,
Planning and Development Services®� 0® �t't 2018
Building and Code Regulation Division ���Ri .aepartment
2300 Virginia Avenue, Fort Pierce FL 34982 County
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION: °
Address: r fl b
Legal' Description: ) 5�P, .31 kt1 �j.SS (_ [` Le IS 31 (, Cr6 -_f� 3y-203)
wr iq�ol -ao$I
Property Tax ID #: `
{ �- 1 �(� �� i f Lot No.
c
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK. ° f
0-roo)L P4Wof) d WS;r\� 30 ib �_tI{— aS
Uhck�Ylle�mtiht o,+VrA
Afl `. �� t r t b 2 �.e ��- -ram �� o �aco � p l� .
CONSTRUCTION INFORMATION:
ne orme under this permit — c ec a apply:
Additional work to El Shutters ❑ Windows/Door
E1HVAC El Gas Tank Gas Piping
_
Electric 0 Plumbing Sprinklers Generator WRoof 1 . Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First FI r: //„ Z 0
r
Cost of Construction: $ 11,000 Utilities: JSewer Septic Building Height:
OWN.ERAESSEE:
CONTRACTOR:
Name (M. - -i' fi r 1imI i.e��
Name:�L/ IVt/ lka/" 0
Address: i�
Company. U `cc /1 d �' C
City:Iy4emoye-f State:(
Address: 14,103 C/
Zip Code: 3yG Fax:
City: Of-%-Q (4/ r&3.?-.( State:
Phone No. 75
Zip Code: �ti G%7� Fax:
E-Mail:
Phone No. 9(0- 3.W �
Fill in fee simple Title Holder on next page ( if different
E-Mail:
S ate County License: — CL%.3a7::3a
from the Owner listed above)
If value of construction is,$2500 or more, a RECORDED Notice of Commencement is required.
i0
1010812018 14:50 LUVIANO ROOFING TAR)863 357 3566 P.0011001
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:_ -
Zip: Phone:
Name:
Address:
City: State•
Zip: Phone:
BONDING COMPANY: —Not Applicable
Name:
Address:
City:
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 Counttyy makes no representation that is granting a permit will authorize the permit holderto build the subject structure
which is In onflict with any applicable Home Owners Association rules, u, aws cr an4 covenants tat may restrict or prohibit such
structure. Pease consult with your Home Owners Association and review your dead or 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 concurren review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms accessaryus to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Co a cement mar
suit in your paying twice for
im r m nts to roperty. A Notice of Commenceme m st be reco and posted on the jobsite
befo�t ifirst jrtspect n. If you intend to obtain financing con ult with le or rney before
com e c 1 o k or r ordinR your Notice of Commence r t.
as Agent for Owner
STATE OF FLORIDA t -
tOUNTY OF .
The forltolng Instrument was acknowledgoj?efore me
this day o OCT4 dl3 rti-- 20 EY by
c y�
ITimO of pars king statement
Personally Known Lof OR Produced Identification
Type of Identification
wgn t@ u70TUvnzraGwiiuvclua nulum
STATUE OF FLORIOA
COUNTY OF
The forgoing instru ;ei two acknowledge fore me
this da6f 90 jw-
Type of
OR Produced lyibntification
MARLINA 09PINea "" MARLINA GODINU
ommisslo my commISSION o(ON14236 commiss Q,,•-0-�jiy �ppp OH # SAWA
�p(PIRaB June 13. 2027 EWIRFS June 13, 2g21
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW I REVIEW' REVIEW REVIEW REVIEW REVIEW
DA
ICOMPLETED
Rev. 8/2/17