HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
� r
All APPLICABLE INFO MUST BE C0 PLETED FOR APPLICATION TO BE ACCEPTED-
Date: u�-�� �� �� Permit Number:
1"
Planning and Development Services
Building and Code Regulation Division
2306 Virginia Avenue, Fort Pierce A 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
RECEIVED
Building Permit Application OCT 19 2018
6GANNED ST. Lucie County, Permitting
BY
Commercial St Lucie CR991lential
PERMIT APPLICATION FOR: Al �d
-- ,
Ad
Legal IDescription:
Property Tax ID#:J b&o - 4 0,3 ' e� 16 445 'e; Lot No. 22�
Site Plan Name: Block No. ,/U
i
Project Name:
Setbacks Front Back:_ Right Side: l ! Left Side:
!PA
unaerims permit —
_Mechanical _ Gas Tank —Gas Piping
electric - plumbing . _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ d 2
Name
City: I State:
Zip Code: 2— Fax:
Phone No.2 D L/doD
i
E-Mail:
i ,c1
apply:
— Shutters
_ Generator
Sq. Ft: of First Floor:
Utilities: —Sewer _ Septic
Fill inl fee simple Title Holder on next page (if different
from the Owner listed above)
Company:,,,—.go1L
Windows/Doors
Roof
Building Height:
MT
City:.)CT Q 1 eG fu Stater.
Zip Code:,, !19,? Z Fax:
Phone No 6
E-Mail JAI JC ZZ ge 4QQ
State or County License WC IVJ L —7
if value I f construction is 2500 or more, a RECORDED Notice of Commencement is required. oTO
DESIGNER/ENGINEER: Not. Applicable
Name: A-.S' ke_a�,7 rli- �
Address. , . /! . CAl I
City: State: /
Zip: 3 = V / / Phone,4 D3 Y 74 O S'VZ
FEE SIMPLE TITLE HOLDER: Not Applicable
Name: =,! �'1r;._�:
Address:
City: r, ir,'.
Zip: Phone:
COMPANY: _ Not Applicable
-
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 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 on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
cnmmencing work or recordine vour Notice of Commencement.
Signature of wrier/ Agent/ Lessee Contractor
Signature of Contractor/License Holder
STATE OF FLORIDA,,c
STATE OF FLORIDA e)
COUNTY OF �_,G/ (,1L
COUNTY OF
The forgoing instrument was acknowledged before me
�
rrk w
The forgoing instrum as kno dged before me
by
this � day of , e A6 T . 20�y
this day of . _ 21
K2is7-/AJ � �a
�� �i2� s� Yc/. �✓
(Name f person ac owledging)
( of person knowledging )
Si ature of lic- State of Florida)
gnature o t ublic- State of Florida )
OR Produced Identification �,
Personally Known OR Produced Identification
Personally Known
Type of Identificati % ocr� ;?�8�, SHERRI FEHLMAN
? c
Type of Identification ��•- ��* SHERRI FEHLMAN
Produced v Commission# GG 187160
a'10AYPpe p
Produced
mission # GG 187160
Expires March 14, 2022
Commission•No. 'FOF��e (S �dT",BWgetNotary SmIca
mr El,,
Commission No. r a�rysOGINery2
im
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
. i
aq " .
10.300
DATE
l
COMPLETED
(:�w
. 1
Rev. 7/2014