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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION- I ALL APPLICABLE INFO MUST BE CdiVIPLETED FOR APPLICATION TO BE ACCEPTED Date: '0 Permit Number. I $ to". 0(0/" — - RECEIVED SC —�— Building Permit Application OCT 2 6 2018 `s1` 9y Planning and Development Services Building and Code Regulation Division Permitting ® St.®n� ment uoC -® 2300 Virginia Avenue, Fort Pierce FL 34982 hucle Ceu�( p� Phone: I'(772) 462-1553 Fax: (772) 462-1578 Commercial Residential �fy PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: 1%&q CVarcJ_' S*, e S L 1: L M95AL Legal Des l ription: gurgr ParK : I- I LIC b Lal- 1-t Property Tax ID #: 3 q ( I - S O 1 - ®0 (a) - qgo -1 Lot No.q_ Site Plan Name: Block No. �o Project Name: nrru A 4 K4_roo -c Setbacks) Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: r'I(,t}{ % OnL7% IQ�,weov4$x�3+��� r»4ktr':til •wr. �C.IC�rGP1ri►:t Co1�� 14 S J- a (t h t- &,, S A-V * S A"r S CONSTRUCTION INFORMATION: Additional work tob erformed under this permit —check all that apply: IIHVAC L_J Gas Tank ❑Gas Piping _ Shutters Windows/Doors Electric, E] Plumbing ❑ Sprinklers E Generator �oof / Roof pitch Total Sq. Ft of Construction: 06 S . Ft. of First Floor: _ Cost of Construction: $ < < S O Utilities:cnSewer Septic Building Height: �b " OWNERVLESSEE: CONTRACTOR: Name it,krzLL Nrvee,Name: 0 L Address: Company:iUc Z0,0q'dr,1 Znc City: Ql i} S+ , G: L State: FL, Zip Code: 3 t(q Sa- Fax: Address: A A H t Ye City: ,S+VC. - )- S I G I-<�r s t State: rc Phone NoJ Zip Code: 34 @ 17 Fax: 7It 7 - 7763 E-Mail: Phone No. %i� 4LF 7- a f a f Fill in fee,simple Title Holder on next page if different E-Mail ( oI,„ (Q Ca Si r-Q r-oo (40-- Co rVI State or County License: CCC( 3D.G 5 7 from the Owner listed above) If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Name: Address: City: Zip: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: State: I Phone I FEE SIMPLE Name: Address: City: Zip: TITLE HOLDER: _ Not Applicable I BONDING COMPANY: Not Applicable Name: Address: City: I I Phone: I Zip: Phone: OWNER% CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I certify tljat 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 inl 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 accordai ce 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 commen�,cing work or recording Your, Notice of Commencement. __as i ure of caner/ Lessee ontr o nt for Owner Signa ure of Contractor/License Holder S ATE OF FLORIDA STATE OF FLORIDA COUNTY OF /i/t& r+, A COUNTY OF M are-r>„ The forgoing instrument was acknowledged before me The fp going instrument was acknowledge before me 4 % this I (day of 0 CXah.v . 20T by this day of ©C,Avb�-r . 20 by Name of person aking statement Nam of perso,} making statement Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification L Produced PL Dti Produced tt'� (Signature ary Public- State of Florida) (Signature of a ublic- State of Florida ) Comm' on No. Commi on No. Seal JOHN J. SAVARESE gopok JOHN J. SAVARESE MY COMMISSION # GG260667 MY COMMISSION # GG260667 a� oF�oa° —1-1 S: September 20, REVIEWS FRONT ISOR VEGETATION S i COUNTER REVIEW REVIEW RPLAN REVIEW REVIEW REVIEW DATE RECEIVED DATE T COMPLETED 71 a tev. 8/2/11