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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION.�oI ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: `1' 7.$ �� Permit Number: Building Permit Application Planning and Development Services - Building and Code Regulation Division 2300'Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial V J�15 .15 RECEIVED NOV 2 8 2018 ST. Lucie County, Permitting Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line X PROPOSED IMPROVEMENT LOCATION: Address: T 11 TCT AMD TNTNRC _Cove n <} PG r1 Legal Description: 11 LUCie County Property Tax ID N: 3534-503-0007-000-2 Lot No. 6 Site Plan Name: MITCHELL 0"NEIL Block No. Project Name: Setbacks Front Back: SV V'Right Side: 17' a n LeftSide: t l DETAILED, DESCRIPTION OF WORK`. CONSTRUCTION OF A NEW POOL. I CONSTRUCTION INFORMATION: III J Ga ank UGas Piping Plumbing []Sprinklers Shutters ❑ Windows/Doors Generator 0 Roof = Roof pitch Total Sq. Ft of Construction:bs ;��se L \ c-O_ S Ft. of First Floor: Cost of Construction: $Coo 6c, Utilities: Sewer E]Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name RORRRT TVANV Name: Address:113 ISLAND DUNES ROAD Company:©QL'CiJ�Oft� City: ST LUCTE COUNTY State: FT, Zip Code: Fax: Phone No. Addre s: C) bcbX 72-M City: �0.�m C !, State: e L Zip Code: 3� t Fax:r1�11 ac&$C_ b2 Phone No.. LO% C E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail: O cd� sou P%v-NA C�" • n� State or County License: C QC. 03 c:t X &1�5- If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPRLEMENTAL CONSTRUCTION LIEN LAW INFQRMATIQN DESIGN NGINEER: _ Not Applicable Name: h s> r ram\ A� MORTGAGE COMPANY: — Not Applicable Name: Addr s• .q hn%\;fin err \ Address: City: hx c\t✓ State Zip: ' Phonel O b '� 2F City: State: Zip: Phone: FEE SIMPLE TITLEHOLDER: _ Not Applicable Name: BONDING COMPANY: _Not Applicable Name: Address: Address: City: City: Zip: Phone: 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 granting a permit will authorize the ermit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or anscovenants 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. n \� C�a�) Lessee/Contractor A for Signature Holder Signature of Owner/ as t Owner of ontractor/Li ense STATE OF FLORIDA, STATE OF FLORI rr COUNTY OF COUNTY F 441L The forgoing instr nt as knowledged before me this day �x . 201 E) by The forgoing in nt was a nowledged before me this 15 day of oTM 20 r by /of f —t�' S" i Ko�et)-F' 1Va44 L4 me of erson making stateAnt Name of p rs n making statement PgsenVTy Known OR Produced Identification Personally Known OR Produced Identification 1We'6f enti Ication Type of Identification Produced I Produced .••`,p'veu"""•.,, DEBBIEB.SABIN Notary Public -State of Flonda ' 4 (Signature of Notary Pub' - ' (Signature. f Notary Publl -` . loMNm•Expires May30,2021 "•.°i,.••" Banded ugh Na6anal NolaryAssn. q�••.,, DEBBIE B. SABIN Commission No. ea ••,.•�"r Commission No. ? . Nota(Sblil"-Stateof Florida - - Commission Y GG 0E9314 My Comm. Expires May 30,2021 'ry,'�oert Bonded through Natwal NctaryMw. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17