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Home My WebLink AboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Num -= RECEIVED Building Permit Applicatior OCT 1,8 2018 Planningand Development Services Permitting Department Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie Ounty, FL Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: . _ Address; / Lljelr- Legal De !scription: Le (', p/m /i/ LOT a.SCANNED Property Tax ID #: � Sag' St Lucie Call tot No. �S Site Plan Name: 4 ,kl d / ll ,d Block No. Project Name: L lY Setbacks Front_ Back: Riiht Sider 2 ,0 Left Side: 2 ` 1/ op . DETAILED DESCRIPTION"OF"WORK. N��O Cv A/5frdG77oAl :51A.J j t /--1W/4Y 2_ s1-041 o ©y'' J',. ��-��, a- a 0 m Si •L� CGS � /,�� r� . CONSTRUCTION INFORMATION. �HVAC ras Tank ❑Gas Piping Windows/Doors® Additional work to be �erformed under tispermit—check a apply: &pbitch Electric Plumbing Sprinklers _ Generator Roof, Total Sql. Ft of Construction: ---J_ N� % S or: 2 Cost of Construction: $ I MWL!tilities: _ Sewer © Septic Building Height: ` OWNER/LESSEE.,' CONTRACTOR Name or- Name: OA—)7� l� 16(_aC Address: '763 S(11 C7OabdIA)L: G•T° Company: - L31anaes LL- , City: jTLI" State: i� Address: Zip Code: Fax: City: A L, `_f State: PU Phone No. - - Zip Code: 3LIMp Fax: � 72-2gLg5 a�l� E-Maild 711TXAe PVC1 4) AIA fl, 0' 04. Phone No. o4- 2&,o -g220 Fill in fee simple Title Holder on next page (if different E-Mail: ed I P EA)c-a) 6 f[., SCOW . &C-r State or County License: Cl SZZL/ from thle Owner listed above) If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. 103 N SUPPLEMENTAL CONSTRUCTION LIEN LAW -INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name:/ Lj riefiUL VALaa Address: A11169" "t City: L iE State: At ' Zip: Phone CZ7 7— FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: Not Applicable Name: 1'9V7Z;r,6TfiTZr" Address: Zfy? W•L/I�'/,�/,11FCT /3�-f�/� City: Oder, 9--/ State: Fc Zip: , — Phone: ?-17D BONDING COMPANY: Not Applicable Name: Address: City: Zip: Pho 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 commencing work or recording your Notice of Commencement. 6mca azzu Signature of Ow er/ Lessee/Contractor as Agent f n---1 STATEDF FLORIDA rz� COUN7 OF 0_ RN LL� � The forgoing instrument was acknowledge befor riCVw this day of 20 ' by utTN � -FE? J e'� e_ i Name of per n making statement Personally KnownOR Produced Idi Type of! Identification Produced a� s (Signature of N ry Public- State of Florida) Commission No. _ (Seal) REVIEWS FRONT I ZONING COUNTER REVIEW DATE RECEI COMPLETED Rev. 8/2/17 Signature of Co ractor/License Holder STATE OF FLORID, COUNTY OFipca The forgoing instrur�en was acknowledged before me this � day of (/ &A,-- , 20&- by _�1- 'e Name of berson making statement Personally Known OR Produced Identification Type of Identificatio ---•-- Produced L— v o YENIA NOV•BARR Notary Public, State of fi_-"\ Commission# GG 5 (Signature df Notary Pub l' - a " Z ��!comm. YENIA NNOY•BARRIO Commission No. t��lic, State of FI Commission# GG 578( expires Dec. 22, SUPERVISREVIEWOR I REVIEW PLANS I VEGETATIE EWON I SE EV EWLE I MREVIEWVE