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Home My WebLink AboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 \a 3 `b Date.,Permit Number: =RECEIVEDBuilding Permit ApplicationPlanning and Development ServicesBuilding and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential _1 PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line Oa PROPOSElJWI' OVEMENTtOCAIION.. Address: ?300 6,Q,44h, 644e 14y6 10eAN E Legal Description: SOt�rnP�n! ©f) 5j 65+A_ e6 LAT 3& RV St Lucie Co Property Tax I D ##: 340D! — 7) D -- O D +f / — ,)00 - S Lot No. 31:2 Site Plan Name: C/ZAI6 Block No. Project Name: 416 L Setbacks Front A5f Back: RightSlcl% - Left Side: o' DETAILED 1DESCRIPTION OF WORK „rt,,,t„��50L_ �1 baUG CONSTRUCTION .;.. INFORMATION: Aaditional worK to e e orme under tispermit—c ec a apply: 0HVAC f]GasTank []Gas Piping _Shutters ❑Windows/Doors Electric 0 Plumbing Sprinklers 12 Generator Roof Roof pitch Total Sq. Ft of Construction:: S Ft. of First Floor: � p Cost of Construction:$-3r71O'� Utilities:�5ewer Septic Building Height: OWNER/LESSEE:_— .._.__ Name i I Dfc gI Name: w�E M RK6 Address: ;boa 62AN'� DM4- Alm Company: HQ4lZ0,-1 VDD16 !fC City: F�LQiP rf4 State: Address: 5,C13 5±9±dy QA_KS Zip Code: 3�i81 Fax: City: GI-PcrCe State: r-Z-- PhoneNo. `77� 3 7 0 — CIS0b Zip Code: D4qgI Fax: E-Mail: Phone No. 17 3bl- $Sla Fill in fee simple Title Holder on next page ( if different E-Mail: hb r (2_QA D W 15G9 mot)-. n e--fi State or County License: OX l g5glo from the Owner listed above) If value of construction is $2500 or more, a RECORDED Notice of commencement Is required. Inty 'SUPPL�NIENTAI: CO T L1EN�L`AU1IINFQRN1ATlON�� . � .*,-�IS.Rt1CTIQN � DESIGNER ENGINEER: Not Applicable �y}S MORTGAGE COMPANY: _ Not Applicable Name:. Q�F02�/ Name: Addres : `� la // fir; L?4P 2 Address: City: Q State: � City: State: Zip: Phone 305— R74— o ejLL Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Applicable Name: Name: _Not Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/iCONTRACTOR 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 Counttyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in co ilict 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. 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 commencin work or recordingour Notice of Commencement Rev.812/17 M ,Y iiA v� 'A U/l�, �d�b Signature of Owner/ Lessee/Contractor gent for Owner Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OF � STATE OF FLORIDA ' �-� � COUNTY OF -� The forgoing instrurqent was acknowledged before me this � day The forgoing instrur� ent was acknowledged before me of lNOV .20�by this f0 day of IVD�/ .20�by �KlyNa C�-ri4 t;,�ad,�, n' CQrH,,r.e... Name of person making statement Name of pers n makjng,statement . � Personally Known OR Produced Identification � L Personally Known OR Produced Identification Type of Identification Type of Identification dosandrg/i'n Produced ''11QQSS Produced � NOTARt'RUBtJd �.VI�vJz��X•► tI ,gTAl�,ppfi.�RIDA 06082559 �� /TT 1972020 (Si ture of Notary Public- 4. a of Florida) (Si atute ofNotary Public- Sta a of Florida ) Commission No— ) Jonv, s A:�B Commission No. ( �- "NOTARYPUBLt REVIEWS � N SUPERVISOR P S VEGETATION SEA TURTLE NGROVE UN REVIEW VIEW REVIEW REVIEW REVIEW DATE RECEIVED µ �ATE iSMPLEi'I]D