HomeMy WebLinkAboutBUILDING PERMIT APPLICATION®I
ALL APPLICABLE INFO MUST BE CONAMWED FOR APPLICATION TO BE ACCEPTECWW`
Date: Permit Kurfiber:
1 1. 110 C,3 1,
RECIE-1VED
Building Permit Application
OCT 19 2018
Planning andDeveloprnent Services..
ST. Lucl Count'
P
Buildingivision e CountV, PermittIng
and Code Regulation M L
2300 Virginia Menuq, Fort Pierce FL 34982
Residential
"X
Phone: (772).4.624553 Fax: (772) 46,24m 578 Comercial Residential
PERMIT APPLICATION FOR: To- Select from droobox, click -arrow at the end Of li
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Address: S-: v,
LegalDescription: (k SCA
13Y
01.LUC1e q%
.:Proper �Y Tax .4510 W3�)L. IRX
Site Plan Name:
Block No.
M ROS cl wct -Cab ojw, GbvCrqL tv
ProjectINa e- :t
�.Setbacks. :Front Back: _,..RightSide:, Left Side:
RE
E T 'ALED11"DESC
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7 A.1in-_x1j.. 9- F0 UflEo- r_0A_1e-1tA7,_L5' ox 4 X 4) k ;L
0—T-JeAne /9 0
TA(l P eo�vc/ #
&&W 14 X ACE
477/Y QW&
N, Sj,,,R
AaaMohp! work ff o'BeLpert d under this permit, o�.check all t=7apply:
... OH
11, 7,
-
RVAC Gas Tank Gas Piping :" Shutters Windows/Doors
E
C Plumbin*g 1-Sprinklers L� ?Jaenerato- r 0 'Roof pitch
Electri Roof
Total Sq q., Ft of Construction.: S Ft of First,F 6or-
q.
0, 0 a Cost of Construction:' Septic Building Height,
$
>OWNE4R/LESSEE:'$T Ai
16NORAC ke_
o
Name
Name-
Add ress:� .��.3:3,54/. .12jO
Company :Mb Wnc, tjc.� 1,Cc-4 -S 6 3
..DOWK - 0-
Ad.dress:. 145-L
_F_
City: _Al!z. State:
Zip Code: J�MOFaxL.
"City: W State: eL
.,Phone No.:
Zip CodeCA. Tax:
&Mail: L7014A1-S0&1)0W(!P_A 0-,L.C.OM
-UA-;-- C)U D
Phohe:'NQ. 10
Fill in fee simple Title Holder on. -next page (if different
-E-Mail: L-ya, I
from the Owner ove) ab listed :
State or County License
W
it value ot1construction is$Z!iqu or more, a RECORDED Notice of Commencement is. required.
SUPPLEMENTAL,G0XSTRLCTI
"
i8,
IN
\F
IAT
J]
,
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:
Ad&ess.
Address:
City:
City:. -
Zip: Phone:. .
Zip:: 213hone:.
OWNER/ CONTRACTOR AFFIDVIT: Ago, . lication'is hereby made to obtain apermit to do the work and installation as indicated.
Itertifly that rid wbrk or installation has.commi2nced priorto the issuance of a permiti
St. Lucie Countoakesno representation that is g6ritingr a;perrnit will ad tho'rize the permit holder , to build the subject structure
which i, in conflict with any.applicable'lH16me 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 ply.
restrictions .which may ,ap
In consideration ofthe.granting of this requested permit, 1 do hereby agree that . I will, 7in all respects, perform the work
in-acc orclance'wit . h the approved plans, the Florida Building Codes and St: -Lucie County Ahiendm.e'rits.
The following ,building permit applications areexemptfrom undergo[ , ng a •full Co'ncurrency,revieW: r oo.m iadditio'hs,_
accessory structures, swimming pools, fences, walls; signs, screen rooms and accessory uses to anothernon-residentialuse
WARNING TO. OWNER: Your failure to Record a Notice of Comhi6ncemdht:maV result , t in your paying twice for
- - - - I . -.. *_.paying
h
improvementsto ' 1h "N , , *:' f Commencementj(nust�be�e�c�or-ded'*and-p'o:s'tLn"d'on.t ejbbsite
ypurproperty.A'; OUCOO
before the first i - nspection''. *If -you, intend to obtain financing, su�iwit-hien:derbra'n:attorney.beforb.
ancing, consult
commencing work or recording your Notice of Commencement.
as, Agent for'Own.dr
.STATE OF FLO. RIDA
COUNTY OF
The forgoing instrument was acknowledged', before me
this — day of. 20, .'by
Uarne 6f.pers6n making statement
Personal ly Kno w-n OR Produced Identification
Type of Identi ' fication
Prod4ed
,3—ig-nafure ofContractor7tHense Hold6r,
STATE OF FLMDA
COUNTY OF_,4-()LAVal '6M ll�VN
The forgoing instrument was acknowledged before me
this AL'Ititlaydif DOVIXY, 20A by
14me of person making statement
Peeson�ally,Kndwn L,_" OR Produced Identification
.Type of Identification-,
(Sigp9ture of Notary Public- State of:Florid6 Notary
C J�g al of
Notalyp bl
0 Issi
No.
Commission No.. (Seal) Commss
REVIEWS FRONT ZONING N'G SUPERVISOR PLANS
COUNTER REVIEWEVIEW R. REVIEW
1ATE
ECEIVED
i ATP '
Rev.8/2/17
fjoilda
V . EGETATION SEATURTLE MANGROVE
ANGRO . VL
REVIEW: REVIEW REVIEW
V
01
DESIGNER/ENGINEER," __� NOt Applicable
MORTGAGE COMPANY:
_E Applicable
Narne:..
Name'
Address... _ � �
•Address:
City: State:, -
City. '
>n State;
?ip: _ Phone :.
=Zip: Phone:.
' 41Jck-
'Y
FEE SiMPLE TITLE N.QLDER . �Mt Apphobl
BONDING COMPANY:
_IVof°Applicable
Narrte:
Address:
Name:
Address:
City: _
City;
.ZZip: _ Phone:. _. _..
Zip:._ Phone:
_.
IIVuvrVCtC/{,VIY..1_KH(•1UKHrtit).VIIi:Applicatior►lsherebymadetoobtainapermitto;dotheworkandinstallationaslndicated..
I crtifythat no work or"installation has commenced priorto the lssuance of a permit. I
in consideration. ofthe grantthg`of this requested. permit; I do hereby -agree that I will, (n fill respects, perform the work
In accordance with the.approved plans; the flodd,i Building Codesand St. Lucie CouOty"At 6ci menu..
Tate, following' building permit applications are exempt from undergoing a-fuil concurrencytedlew. rcoq dditiopt,
accessory structures, swimming pools, fences, walls; signs, screen rooms anil accessory uses to another non-residentTafuse
WRNING TO OWNER. Yourfailure to Record a Notice of Commencement may.result in your paying twice#or
improvements to your`property. A Notice of Commencement must be 'recorded and posted on the jobsite
before the first Inspection if you ihtend to obtain financing, consult witfi tender or gri attorney before
Signature of.pWri r/ Lessee/Contractor as Agent for; owner" ' , gna ; ;rebf Contractor onsq' aide
STATE OF FL DA STATE OF FLOLSUA..:&(DiQ,
COUNTYOFNL.1ti- _ EOUNTYOF._Nil-.
The forgo g Instrument was acknowledged before me The forgoinglnst'ru " entwas acknowledged,before me
this dEly of his,iyO K-Oc.i26ij �af 291Xby
i
wl . YUt o(;t
N" e'of person akingstatement N ; me ofperson making statement.
Pef;onally nown_ OR P_ roduded Identification Personally Known _ 1/� OR Produced Identification .
Typep( Identification Type of Identification
.— 4ubt�c—,, ._
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VIEWS FRONT ZONING SUPERVISOR PLANS
VEGETATION
-SEA TURTLE MANGROVE
+ COUNTER REVIEVIX , _REVIEW ;REVIEW
'DATE
REVIEW
':REVIEW REVILIN
,
:RECi:IVED
COMPLETED'