HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �r —1 '—� Permit Number:
�® RECEIVED
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"®° Building Permit Application FEB 12 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) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:`
Address: 359 S N IG inois FT— Pi E12Cc-_- i—C� �Jc1G►��- .
ti�TE�
Legal Description:
St. Lucie Counfir
Property Tax ID#: I32c. ��� Uo�2 voo Lot No.
Site Plan Name: Block No.
Project Name: kkwc V9 C_
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
SIA,G c,nJ 'Sh5f,o1c ,on o far kwe u1k2 Into rr-e
CONSTRUCTION INFORMATION: !:
rtlona war to e e orme un ert is permit—checkall appil
2rHVAC Gas Tank ❑Gas Piping Shutters iz n
Windows/Doors ,r
o_•
p g _
j'�� �y
L—`fElectric LJ Plumbing ❑Sprinklers Generator ;v Roof `Roof pitch
Total Sq. Ft of Construction: �� I)L Sq. Ft. of First Floor: `Z l
Ln� � t
Cost of Construction: $ t s�� a Utilities: Sewer Septic Building eH ight:
_
OWNER/LESSEE:—
"CONTRACTOR:'
Name Name: i C 44.4,f,.'+ . U ,._....
Address: N fCr n SS (i''U y t, Company: tJyJ D ✓ '0�'7n !►ric
7 •�`
"Ci State: Address'
Zip Code: 3 i!5 S 1 Fax: sty. - .Y State:_[
Phone No. - - Zip Code: Fax:
E-Mail: Phone No. j b
Fill in fee simple Title Holder on next page.ILif different E-Mail: - +• � + "� ; � _ irogTa-•ei7
rr
fro i the Owner listed above) State or County License: f [>
If value of construction is $2500 or more, a RtcORDED Notice of Commencement is required.
S 6z.
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SUPPLEMENTAL CONSTRiJCTION°LIEtV I:AW INFORIVIATtON
-
,`'`` '; : r '
DESIGNER/ENGINEER:'.' , Not Applicable
Name: /VAdc2 i--1(rj4/
MORTGAGE COMPANY:
Name:
Not Applicable
Address: 58Lr s 6/riivLu ,02
Address:
City: 66she_n Stater
Zip: `1LS"Z!. 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'M6 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 other non-residential use
WARNING TO NER: Your failure to Record a Notice of Commencement ma a It in your paying twice for
improveme s o your property. A Notice of Commencement must be re r d and posted on the jobsite
before the irst inspep. If you intend to obtain financing, consult wi le der or an attorney before
commen nPlwork of rec�6rdine vour Notice of Commencement.
of Ow/Sgreessue/ContrNtor as Agent for Owner
STATE OF
COUNTYI
The forgoing instrument was acknowledged before me
this 11 day of reh 20j2 by
Name of person making statement
Personally Known OR Produced Identification
Type of Identification
Produced
`(Signature of
Commission t
FRONT ZONING
COUNTER: I REVIEW
Rev. 8/2/17
-d
STATE OF
COUNTYI
The forgoing instrument was acknowledged before me
this 1/ day of JAGS 20_�2 by
Name of person making statement
Personally Known �� —OR Produced Identification
Type of Identificat0n
Produced
KRISTY SEXTON ignaCure of Notary PubVie-State
N public. State of Flod a e KRMSM
qqtt��ryy
iecNbmmission#GG208344 mmission No. � ....i e '
My Comm. Expires Apr 11, 2 2 e Commission a GG
ed through Nadmul Notary A n.�/ J My Comm. Expires N
Banded through National)
S EGETATIEATURTANGRO
REVIEWOR_I RE REVIEW— I PLANSVREVI WON I S REV EWLE I M EVIEWVE