HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE CONWLeYED FOR APPLICATION TO BE ACCEPTED
Date: a.1a.� 1
Permit Number:
Building Permit
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
n0-a.- Cr., I
RECEIVED ANC
FEB 2 6 2019 BY
St. ucie
ST. Lucie
Commercial Residential V
PERMIT APPLICATION FOR: Roof : ,M���� n II
Address:
S
13PiC1 ANO PKO-
15it1rt )W%ft - 1N COMMON ELLML-NTS (og 784 Z.o07)
Property Tax I #: ySCJZ'501-15QCo- 000- 6
Site Plan Name:
Project Name:_ d(Qi1 tr;h(�d
Setbacks Front Back: Right Side: Left Side:
Lot No.
Block No.
f DETAILED DESCRIPTION OF WORK:
e�;sF:rl DO-( 10-1,1� with N2 W 5Y MWC�1 "06 1)0,
Po 14
CONSTRUCTION INFORMATION:
I,JHVAC L-1 Gas Tank UGas Pi
Electric 0 Plumbing F_15prinl
Total Sq. Ft of Construction: _ 10 $Q�
Cost of Construction: $
ing UShutters ❑ Windows/Doors
srs 1:1 Generator Roof ® Roof pitch
S Ft. of First Floor:. U
Utilities:SewerUSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 901,F Rwritt�N
Name: ee,
Address: l36q 2
t5 61V ,
Company: PIIK 00� ; n¢I •
City: �gLUVI WtAn State: El,—
Zip Code:.34 9 57 Fax:
Phone No.
Address: 1299 Sty VC .sj-
City: 64- SaiAf' bu-0 e, State:
Zip Code: -Sqg 3 Fax:
Phone No.0 7. - J2,q'a113
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
NF h.--1..—_-._..__e__
E-Mail:
State or County License: CCe 1 331 L { Q
•• --•-- —• .....•�.•........0 o qc�w m m�rr� 0 RGUV6VGV 11ulice of commencement Is requires.
SUPPLEMENTAL
LIEN LAW INFORMATION:
Name: '
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
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 andcovenantsthat 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 concurrenry 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
boemro@re he first
e w kpe r?Pr AAf you intend o obtain financing, consult with lender anAtorney before
- - -- n.c vi IV Ira 111C11{.CI
lit"
Signature of wner/ Lessee or as Agent for Owner
nature of Cont ctor/Ucense older
STATE OF FL" IDA
STATE OF FLR¢[tIDA
COUNTY OF
COUNTY OFL \r t t LUCK 2_
The forigoing instr�+ment was acknowled before me
thIsla day of by
The oing instru t was acknowledgebefore me
this
ayof 20 by
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification
Type of I Ica ior�
Personally Known OR Produced Identification
'fication
Produce MICHELLE GREEN d
IeHry
Type of Ide
Produced ;gi Oil¢. MICHELLE GREEN
Public - State of Florida
.y. Commission N GG 286318
`
g ,y. ary Public -State of Florida
M y Comm. Expires Dec 20, 2022,
a Commission k GG 286318
ors`.,. My Comm. Expires Dec 20, 2022
n through National Notary Assn.
Bonded through National Notary Assn.
(Signature of Notary Public -State of Florida)
(Signature bff46fary Public -State of Florida )
Commission NOG� (Seal)
Commission No. �6k
(Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
tev 8/2/17