HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE
INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / V 1 "i i / 1
Date: �`" " a� % o Permit N � on qp- IF
=O 7 /, ' 1
RECEIVED
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Building Permit Applicati n DEC 2 0 2018
Planning and Development services Permitting Department
Building and Code Regulation Division St. Lucie Count FL
2300 Virginia Avenue, Fort Pierce FL 34982 County,
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 5'7U4 C:4ruc Al,f`arl KL
Legal Description: puft`
Ifft
Property Tax ID #: 3 L(0 "l -- It 3 `0 6 0) C)OJ - S Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: RV A
Vo hl aM+ Q�L of c,lal� i YI V _/ �j 19 mac, 0 a LP�-; a�
1JtV� �OOrS O .}�r;0r cu/na K`4&en eA� Wa irozo. Ca,birte3
CONSTRUCTION INFORMATION:
1JHVAC I-.J Gas Tank ❑Gas
11 Electric 0 Plumbing ❑Spr
Total Sq. Ft of Construction:
Cost of Construction: $ .2 O o lo. in,
Piping
nklers
[]n_Shutters
Generator
[]nWindows/Doors
Roof Roof pitch
S Ft. of First Floor: _
Utilities:cnSewer OSeptic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Oa:l a i Pb V
Name: ran
le gauthier
Address, 0(0,4 O S E e o A I>l'
Company: Above
And BeyondDeveloping Inc
City: Fo I4 t.Cc state: J_L
Zip Code: `ia 81 Fax:
Phone No. 7 -7 a- cLg0 2� k e
Address:
sw ianca ve
City: Po
Zip Code:
-772-579-5759
Phone No
Lucie State:_
Fax:
E-Mail:
Fill in fee simple Title Holder on next page ( of different
from the Owner listed above)
E-Mail: Fran leg gmal .com
State or County License:
If value of construction is 525uu or more, a RECURUEu Notice or t.ommencement is requireu.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:g=Bf-no.cz) .1�0YlFZS
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Addres!j7J�-d9 4Z6 /67 f
0 .s4
Address:
City: , ;Am
Zip: '3316 Phone
Stater
_ o
City: State: _
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
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 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 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 pgagel on the jobsite
before th rst ins ion. If you intend to obtain financing, consult with lender o before
comm In w recordin our Notice of Commencement.
Sign of Owner/ ssee/Contractor as Agent for Owner
SignaureofContractor/LicenseHolder
STATE OF FLORIDA L f
STATE OF FLORIDA
COUNTY OF L �I
COUNTY OF w I .
The �ngnstr as ck ledged efore me
this odayof 20A by
The fLUing inst 'nt wrnas cknowledged before me
this n20 I by
From& aogf )et
FronK C �hi'Pr
Name of pers n in statement
Name of pelspwKaking statement
Personally Known OR Produced Identification
Personally Known !! OR Produced Identification
Type of Identif
Type of Identification
Produce
Produced
(Si ature 3FyStR�FkAr)C19VhLL
P ' `- Commission N GG 034T55
Commission No. '%_
o$ eaSept6ili�129,2020
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(SignatureNota
Commission No.
u -
REBECCA A. ALL
.,eCammisslonp _34755
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17