HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:0 1 a S 119.
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Permit Number:
RECEIVED
FEB 29 S 2019
Building Permit Applicat g-PLuciecougv, Permittftl
Commercial Residential V/
�A
Address: \ C-) \ e_•C-c r-c-\e
Legal Description:T Cgjj-SS of ce-1 LxlrcccrcJ�ocl �a\xJliviSicr� of l0\S �1 cl
\Y�c_tvs�v'2.���i 10�5\�-lRCncl,..ns�..e c-� ._r�nvrti�r3e�ccl <1vc.�t-Y-1 b\GGIL�
PropertyTax ID #: 3rJ3� - 50�—OGZ-1 — C310 c:5 Lot No. 1 fir\ g
Site Plan Name: \ a \ YLt caq e- C ky-r-\-,e -F-'C 9-e1C.A. fit_ J 4 C1$Z Block No. a
Project Name:
Setbacks Front Back: Right Side: Left Sider
-PG1;0 S-1h n0 Y-GO�
_Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ ZZ O G O
/ .2 0
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
0WNER/LlE3SEE:
CONTRACTOR:
Name-T-rOW
Name:
Address: %CG CA<:Ae-
Company:
city: A:si-q,:g State: Fl_
Zip Code: 34q &;k Fax:
—
Address:
City_:' State:_
Phone No.J<o 1 Ci\ Cl0
Zip Code: Fax:
Phone No
E-Mail: Sc,\-t--Cc. — ebe,\\5CA-A1Y-\
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail
State or County License
oc
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
PP IM"MrA GONST
UCTIO IE W f
Q IYArTi ON:
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 Assocation 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 p operty. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspectWn. If you intend to obtain financing, consult with lender or an attorney before
commencine work orfefcordine your Notice of Commencement.
of
as Agent for Owner I Signature of Contractor/License Holder
STATE OF FLO� A ' STATE OF FLORIDA
COUNTY OF �. 1 U c\� COUNTY OF
The f rgoing mstr ent was acknowledge before me
this r day of � 20 by
'\kt"k SaAkA-eSe
Name of pekson making statement.
Personally Known OR Produced Identification
Type of Identifica
Produced ion L'y) I,
The forgoing instrument was acknowledged before me
this _ day of 20_ by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of NotaryP MARIEGNEiJ$
(Signature of Notary Publi
DEAN '�v�- MI ION#GG 022023
Commission �s2sO - �FJ(PI
No. mber 16,2020
Commission No.
a Bondepi N°IM'�°6ricUndenvdters
•'-,rtoF
to
57
REVIEWS FRONT ZONING SUPERVISOR
PLANS
VEGETATION
COUNTER REVIEW REVIEW
REVIEW
REVIEW
State of Florida )
(Seal)
SEATURTLE MANGROVE
REVIEW REVIEW
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