HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: Z
4` RECEIVED
Building Permit Application JAN 17 2o19
Planning and Development Services
Building and Code Regulation Division 6'T. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential _V/—
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line BY
Address: 3105 &,M Kt)e ' )r J��+ S ier'- _ 3HgS1
Legal Description:unc4p—cor\o roe n�ni L'��.�-�anzlr�1 ni O'll �oR isq+uoif")
Property Tax ID#: 13a'1''COI- 00gl— C')00-3 Lot No. Q 1
Site Plan Name:
Project Name: VV (cTzy) 0 A_o S
Setbacks Front Back: - Right Side: Left Side:
30c..A u2
�HVAC I—1 Gas Tank
Electric Plumbing
4ec-4-i 09 .5J
Piping
Sprinklers
Block No.
Shutters ❑ Windows/Doors
Generator Roof = Roof pitch
Total Sq. Ft of Construction: 5 Ft. of First Floor: _
00
Cost of Construction: $ 10. `1 `� S . n'x Utilities: _ Sewer Oseptic
Building Height:
;O`WhIER/LESSEE ' fk
. Fib: 'H �...... N+} �n...uw..N.`z .iX. S. " "t
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NameVlrck%c\%CL'
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Name: t�Qob2C'�
Address: 31b8 &A� \ �� 0i
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Company: OIAQ �T�SiLrnS
City: F-t' Stater
Zip Code: 3 N GS ( Fax:
Phone No. 57K- o2Z09-9(o56
Address: \lam
City:
Zip Code: J`1c1$2
Phone No. TI Z-�Ai0c-12Wd
State:
Fax:-nQ-(4(ovl9'2D
3
Fi
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail:5m5 0lo ce c.esc
State or County License: r,UC c SL 103�
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUP:TAECONTRJCTIEN.. 1�lFOR'MT�Of
�f`"
x.. .
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City:
Zip: Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
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 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 recording vour Notice of Commencement.
D( ,s0' JZJ '_
X 2240L ( '
Signature of Owner/ Les tractor as Agent for Owner
Signaturdof ContractD41.l ense Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTYOF
COUNTY OF Sk lx.,.ci9.
The forgooing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this j�'day of'So_r u mrg , 2059 by
this �'�Uay of $n 20 1q by
Name of person making statement
Name of person making statement
Personally Known / OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of Identification
Type of Identification
Produced //
����y(�%idtl�
Produced
%%�iO.�LQ�UGAu.OLc.
(Signature of Notary Public- State of Florida j
(Signs ure of Notary Public- State of Florida
Marie Sarah Music
ade Sarah Music
Commission No. �9/2139NOTARY PUBLIC
Commission No. FF9/21317 QQOTARYPUBLIC
STATE OF FLORI
M."o
A TATE OF FLORIDComm#
DO:
FF912137
ql' � .omm# FF912137
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9
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17