HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APP ICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE.ACCEPTED IQ
Date: Permit Number: 1 U(omc
RECEIVED
Buildiing*ermit Application Nov ®� Zp18
Planning and DevelopmentSerylces Department
permitting
Building and:Code Regulation Division( ty tic� . �,_. ce86 rivstuF�ejCountY
2300 Virginia Avenue, Fort Pierce FL 34982 a P 1 +••
Phone: (772)462-1553 Fax: (772)4621578 COni mercial 'Iresldd tl° I"t
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PERMIT APPLICATION FOR; 'To Select from dropbox, click arrow at the end of line
Address:
S
Legal Descri
tion-TY\AVL,� r\ LtN-.-c'S 1 ? .::% DS, — _F, LIB.. (o
Property
Tax ID#: 3-/0,2,-6-&e1' 05S,'3 —moo/a Lot No.
Site Plan
Name: Block No: _ ir L
Project
ame:��-�
Front Back: Right Side: Left Side'
Setback)
"i DE AILEDDEdSCRdIPTIONOFUUORK� , 4k$' "t
MANNU
BY
St Lucie Cou
'Additional. workto e e orme un er t is permit =—check all apply:
HVAC " Gas Tank Gas Piping _Shutters Q Windows/Doors
❑ Electric 0 Plumbing ESprinklers Generator Q Roof Roof pitch
Total Sq. Ft of construction:' S . Ft. of First Floor: _
%'
Cost of Construction: $ Cy j C+G�C� Utilities:0Sewer Septic Building Height:
��f
}OWNER/LESSEE.
-�... .3�.._t_�....0
Ct3NTRACTORr�.
NamelLC�t4�«QPn1-
Name:=�.w�:�
.. Address S74.b�i f3i�ch ��
Company .. —te_
P: Pr �G State: j�L
Address: l�%C:
..
Zip code: 34�I Z Fax:.
City: r• -�- State-'t---.
_,.
Phone No. � � 2 - 349-y S39
Zip Code; 34'ef4 Fax:
E-Mail:M', e_lle-lctsA Q Ao-E' O j.Cem
Phone No.-?�2-7
Fill in fee simple Title Holder on next page (if different
E Mail` �w.i : cJ. �cUw v\sZ�c�' l✓li'. :. tC
from the Owner listed above)
State or ounty License.,-- _ /S ���/ 1 3 .
If value of construction is $2500 or.more, a RECORDED Notice of Commencement is requires.
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SU PLEMENTAL CPONSTR{UCTION LIEN INFiORIVIX
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DESIGNER/ENGINEER: - Not Applicable
MORTGAGE COMPANY:.
Not Applicable
Name:
Name:C&rf-erSfafe (3ank
_
Address: __
Address: Po &je. 9i�02
City:. _ _. State:
City: Girnfex- wye_n
State: FL.
Zip: Phone
Zip:`3.149$3 Phone: SSS-
863 ..Z 7.6S.
FEE SIMPLETITLE HOLDER: Not.Applicable
BONDING COMPANY:
Not Applicable
_
Name: t &f
Name:
Addresk s-9-oq Bt�t t, De-,
Address:
City: , eye_... 4E . C..
City:
Zip: 3 T Z' Phone; ;FV2-34j9l Ns39
Zip: ',Phone:
OWNER/ CONTRACTOR AFFIDVIT Application Is'hereby made to obtain a permit to do the work and installation as.indicated.
I certifythat no work or installation lias commenced. prior to the -issuance of-a.permit.
St. Lucie Count makes no representation that is granting a permit will'authorize'the ermit holder to buildthe 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 l 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,
accessorystructures, 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
rnmmanrino.wnrle nr rprnrdino vnrrr Nntirp of Cnmmpncpmpnt_
i atuce of Owner) essee/Contractor as Agent for Owner
ignatu a ocef'Contractor/Lier
STATEOF FLORIDA
STATE F FLORIDA • ,,
COUNTY OF .t �[ -0
COUNTY OF til`��
The for oing instrument as ckn wledgecf efore me
The forgoing instru ent was acknowledged before me
.
VIL day of 20jZby
this _ j. day of 20_j by
s
Ila
JG1w1is0Yl�WY1���,
IC& .�
Name of person making statement
i Name of person making -'statement ✓
sonally Known OR Produced Identification . _>'
Personally Known OR Produced Identification
�P
of a of Identification J�)
l� C�
Type of Id nufication
��.
uced .... _
Produced
rA
a11,/_�
nature of Notary . u 'lic- S ate of Florida)
(Si 'ature of Notary Public- State of Florida) ArrW
mission No. Q Zj (Seal)
NOTAR
Commission No. V—r' r .7 :. ;( j; 'STATE'
Comm#
Expire
REVIEWS
FRONT
: ZONING
SUPERVISOR
P NS
VEGETATIQ,N
SEA TURl°L?' �''
j11IANGROVE
COUNTER
REVIEW
REVIEW
VIEW
REVIEW "
IREy_L�:
;� I;fVIEW
DATE-:
e� 014.1
� ifis :_1 ctii : :
a ens+ d •i 3?k �+'+.
e 1 1�`: ^q
RECEIVED.
_`
DATE
COMPLETED
11 •7ll
Rev. 8/2/17