HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr 14
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ALL APPLICABLE INFO MUST BE COMPLETED FOR _APPLICATION_TO BE ACCEPTED
Dater f A. \ 9i Permit Number:
s . a - RECEIVED
-�•
Building Permit Application JAN 17 2019
Planning and Development Services sT. Lucie County, Permitting
Building and -Code -Regulation Division. _
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1S78 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line SCANNII:n III
Address:
Legal Description:
5
Property Tax ID #: �D I- tO��J' O119- OOO —1 Lot No. 7_94-30
Site Plan Name: Block No.
Project Name: 0-rr'�f—k-fom�0,-24
Setbacks Front Back: Right Side: Left Side:
5ot'112 PoOL fie�n5 sys4err�
11HVAC ❑Gas Tank
11 Electric 0 Plumbing
Total Sq. Ft of Construction:
00
Cost of Construction: $ lT -7 to • v�r
Piping ❑_Shutters ❑Windows/Doors
nklers ❑ Generator ❑ Roof ❑ Roof pitch
S Ft. of First Floor: _
Utilities:❑ Sewer 0 Septic
Building Height:
OWI�—ER%L SEE: ,
r1+.. .� '
CONTRA TC OR:
rs4.
NamelAY,1 prn Tron`b1ec
Name: ZccwgoL
Address: 510$
Company: _Z>-6\0X Er�g=n"
SI�S�cmS
City: q--+ P-etrp Stater
Zip Code: 54051 Fax:
Phone No. r7r72-2-05-0555
Address: % nO SmoAlw�L1 lie
_
City: C-+ 1p-, e try
Zip Code: 3tiG$D Fax:"1-12-4bb-
Phone No. `7-7a- gknL?-.-=)b%o3
Stater,
193'7
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: Srr�So ��Cen es
Gd
State or County License: CVC , OS &o sl
If value of construction is $250D or more, a RECORDED Notice of Commencement is required.
r
S11P .0 M'ENTALCONSTRUGF10 LIEN LPVII IN
,wucr
ORMgTION, _
UM .
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City: State:
Zip: Phone
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
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
commencing work or recording vour Notice of Commencement.
A
14 /� l/ e �✓�
Signature of Owner/ LessWContractor as Agent for Owner
Signature of Contractor se Holder
STATE OF FLOR�IDA{A
STATE OF FLORIDA
COUNTY OF_ 71' Wc-,
COUNTY OF 5-{
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 1(4�'Uay of 20)_q by
this 6fbayo�nri� 20_�q by
g,hc'ekZfa_\\nCAL-
co l+ ZEQIICcic
Name of person�making statement
Name of perso making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Pr.,00d,uu,c/ceedd.
(Sig ature of Notary Public- State of Florida )
( ig ature of N Lary Public- tafe of Florida
Made Sarah M
No. 1 NOTARYPUB
sicCommission
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No.
MadeSareh Mu(213STATE
OF FLORIDA
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n NOTARY
Comrt6i FF912
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TAR OF FLO
Comm# FF6121
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Expires8/241
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17