HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE
INFO MUST BE COMPLEI ;_�}`FOR APPLICATION TO BE ACCEPTED
Date: �— I / —I Permit Number:
RECEIVED
Building Permit ApplicationNov 2018
Planning and Development Services ST. Lucie County, PermittlnQ_
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772)'462-1578 Commercial Residential
PERMIT APPLICATION FOR: k.q, _ 11ha� b`1+_
Address:
Legal Description: / er J /l� L d 1 a , l2,' / f li�
Property Tax ID#: -3y%�-.5/o Lot No.
Site Plan Name: Block No.
Project Name: NQ. / r, 1-_a.A, o G..Slfl /
Setb.a
Front
Back:
Right Side
Left Side:
_Mechanical _
Gas Tank
-,—Gas Piping — Shutters
_ Windows/Doors
Plumbing
—Sprinklerserle,ratpr •a._uk4wY4:
« R�af Pitch
sConthioTotal SqFof t
{ s...
Sq Ft. of First Floor:= 'f 7q
Cost offConstruction $ ,1-2
7,��`�
Utilities ' 'Sewer _Septic
Building Height.-
Name%/Nc //�C ,QivriwS��/
Address: 315 1 �S 4 ^L
City: /I 6�T s�� ke/ '� State: _
Zip Code: 3 1/5 SY Fax:
Name: ['asTq Cc�S' o apaay f'
Company: /�i°asl���.dd�ys oz
Address: 3 v �' �� t'
City: 1411 4 State:
Phone No.
Zip Code: Fax:
Phone No 2 (o— Y75V
E-Mail:i
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail C�e7ii�+iv/�ozr,Li �+;s �s•y
�i / o� �,
State or County License Mc
0-0-3 4 a>
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
i
S PPI.EAN FNT, 00.L CQ S IC?N L.IE LA I'N EREMANT]"M
DESIGNER/ENGINEER: ` _ Not Applicable
MORTGAGE COMPANY: Not Applicai le
Name:
_
Name:
Address:
Address:
City: State:
City: State:I
Zip: Phone
Zip: Phone:
I•
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is)Tereby 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. Notice of Commencement must be recorded and posted on the jobsite
before the fi nspection. If yo Intend to obtain financing, consult with lender or an att ney before
comme ork or ecord' our Notice of Commencement.
ignature Owner/ Lessee/Contractor as Agent for Owner
Signature ntractor/License Holder
STATE OF FLORID /
STATE OF FLORIp�A
- ,
COUNTY OF y��r�l7`
COUNTY OF Yi'/.¢��/�
The forgoing instrument wa acknowledged before me
this day of wit^+. p 20 ! P by
The for oing instrument was cknowledged before me
this day of /t/bv0.+� �`• 20_ by
Name of person making statement.
Name of person making stat ment.
Personally Known ' 'c i
Type of Identification '"' "'�f RICKY CARL CocHRAN
Produced '� N®IOrYPubNc- State,ofFlorida
mlexlOn O GG 172136
1•�
MY COMM,C9mm, Expires Apr 26, 20n
° � � i �f11Y�k+{111tnN�h t�lio�l Note ryAsan,
�
Personally Known -�R Produced Ident' '
Type of Identification yARpN
Produced RICKYGA�S;eo1Flonda
v 91
`::Commission GG 1r 26 2022
.: mm E%oles , I Assn. ,
'
• 0GmuONolary
.,,�u,��SS;.•'' Hp�xu!dlhtoullhN�
(Signature of Notary Public- State of Florida)
(Signature of Notary a of Florida )
Commission No. (Seal)'
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
j
COMPLETED
ev. 8/2/17