HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI
All APPLICABLE INFO MUST BE COMA hTED FOR APPLICATION TO BE ACPEPTED
Date: I Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (77;2) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Building Permit Appl
Commercial
RECEIVED
ation
NOV - 2 2018
Permitting De _artment
es rttkie FL
Address: d of e �_L rilke s RA- JVHIVINCL)
BY
Legal Description: r'oo 1 &_ -v Gl a s k r'e- St I I de County
Property Tax; ID #: em/ Lot No.
Site Plan Name: Block No.
i /
Project Name: Sa+-e et.- ��-. e 1osv� r e eFur l sZ met- C,
Setbacks Frort�Y� Back:, Right Sider. t Side: R,
Ci-e.e��G/occnre �r �KisT+'if.c,_ �0 0 l
✓Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
I
Total Sq. Ft of Construction:
Cost of Consi'�ruction: $ tq, 000
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LMASS LE:
CaN7RA OR•
Name D'�r_r ey 1 i c ZA.i,c.C+- {;Name:-'.
Address:
.Compa"ny;
City: Fo ►-f— P,' o f-ce. State: �.
±Aciclress:'
-City: State:
Zip Code: ;34+01 Fax:
Phone No. (0123 )- °I 2.2 - o 3"Zip
Code: Fax:
E-Mail: rlc'T-(eu �i s z . k:ei- _ .C.OI-vim
Phone, No,
Fill in fee si ple Title Holder on next page ( if different
E-Mail".
State,or.<C unty License
from the Owner listed above)
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: ' _ Not App
Name:
Address:
;CityState:
Zip: Phone-=
FEE SIMPLE TITLE HOLDER: ; Not Applicable
Name:
Addressti:,'
-Zip:... Phone: _..
MORTGAGE COMPANY: _ Not Applicable
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 County -makes no:representation that is grantinga permit will authorize the permit holder to build the subject structure
which is in conflict with ahy 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"6f 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.
i
Signature of Owner/ Lessee/Co/actor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this _2- day of 201k by
this day of 20_ by
1 l�s 2 pro a.,,a
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identifica, on
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State lorida)
02N m
(Signature of Notary Public- State of Florida )
•
0r2 X a
Commission No. (Seal)
U_
¢ W N
ommission No. (Seal)
o �
�zom
-
cc:R C
REVIEWS
FRONT
ZONING
SU
PLANS
VEGETATION
SEATURTLE•
MANGROVE
COUNTER
REVIEW
R
c°,
EVIEW
REVIEW ,
REVIEW-
REVIEW
DATE
= Y o
RECEIVED
DATECOMPLETED
Rev.