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Home My WebLink AboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLEl cu`FOR APPLICATION TO BE ACCEPTED -----Permit NumberX\G-�"dr°�p --_- RECD JAN 112 f9 Building Permit Applic ticknieCornlltfln0 Planning and Development Services SCANNED Building and Code Regulation Division BY 2300 Virginia Avenue, Fort Pierce FL 34982 County Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential St. ucie _ PERMIT APPLICATION FOR: �U�.�.,��.S��,ga ��T�` ,•\- �PROPMINE-. :;:- Address: 1 i O G kR)\(SLiS P Q AI> Legal Description: 13:1*- 39 Tt 3M,5VI CZ�"IF- 45V-13 5:rC OF � 93i•d3 V% 0 3: 64 %N- e3z- NB \%6b -aNQ r7o5-d36b b5 Property Tax ID #: `� ` oorCi - Q1%Q - S Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: D At)'D�DSG1 ®OF$WQft+ t z�' IN OR,� FN s G 5O4--> C•s-A`~-. t- PC�d36��N\t C��tOLAIJ�I �N10.6k A 0 `� �- �� r s � •� � �x,��• ""` � •.�" . ¢. ,'' - �C�ONSRaT MAN rtiona wor to a pe orme under tis permit -check all that apply: _Mechanical Gas Tank _ Gas Piping _ Shutters -Windows/Doors Electric Plumbing Sprinklers ;! enerator Roof _ _ _ _ Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ a 9 5l0 Utilities: —Sewer _Septic Building Height: ® E tLESS'E CaN ROOM ' Name= Name: ' �E �i' A11.N.— — Addres"s?`-W9 • a'` -.G'S D Company:' City: �� aC ir' - State.' Address- ' A7 - vGA0 trh State:F't- City: I Zip Code:3W) 5 I Fax: Phone No. '77A 'Hopo " 671+ �o Zip Code: -96 O Fax: E-Mail:�Cr, bh� b�\50kth�t3'a Phone No Fill in fee simple Title Holder on next page (if different E-Mail \t'( t t �A �.�MD 1 OP l State or County License from the Owner listed above) If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. _ Not Address: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: _ Not Applicable •.. Zip MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: _Not Applicable Address: City:_ 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 rnmroanrina %A,nrlr nr rornrrlina vniir Nntirp of Cnmmpn rpm ent. ..................`yam..... .. ........... ..... .-_ _. __.... St ignaturevf Owner/ Lessee o[t r_actor kagenffbr�wner Signatdrerb. _Cord aA for/[ie6hge oliier STATE OF FLORIDA- Q,^,r�I,,� STATE OF FLORIDA (� ,I' COUNTY OF v'LI.tA,Q%1 IWU�1 COUNTY OF `1(LfLtt i K(AJLf The goin instrp w a knowled efore me this�dayof_\\��J20�by The f going instryytt nt was acknowledg efore me this �day of_1�20 by Robert- 4'a I I o (, 4- R�I (Name of person acknowledging) (Name of person acknowledging) T � fbO (Signatu e f Notary Public- State of Florida) (Sig t re of Notary Public -State of Florida ) Personally Known OR Produced Identification Perso Ily Known V/' OR Produced Identification Type of Identification Jenni L. Adkins Produced— 4 TARP PUBLIC l STATE OF FL-0RIDA z Type of Identification Jenni L. Adkins Produced 9�' OTARY PUBLIC -ESTATE OF FLORIDA Commission No.' ° "2 i Commission No. = Cd�RhGp61910 C)00061910 roc 19�� Expire"s 1/11/2021 1e�0. Expires 1/11/2021 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.7/ZU14