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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE CC:...'1ETED FOR APPLICATION TO BE ACCEPT` -,f, um Date: Permit Number: G RECEIVED Building Permit Application 0 T 17 2ot3 Planning and Development Services Building and Code Regulation Division ST. Lucie County, Permitting 2300 Virginia Avenue, Fort Pierce FL 34982 y Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ^ Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III Address: Fy Property Tax ID#: I423• SOZ' oboa OX-3 Lot Site Plan Name: ToDuneS POA Block No. Project Name: 7C Dutia f 6A Setbacks Front Back: Right Side: Left Side: ;- P. a ,mryry i 7 i s� N --/ £. ,�� r g £` .. x t f� k - a •:t z r 0 : 11 1 it y. Q 1At i K D£SCRI ION 0F YY CfRtx ,aa i_� t o xaiez � II i, i t t n �k V ti _s. y a a ti s _ _. ._._ .. _........ ex„ .. Ins -fall new 4' mdo I Tence. Fendtvylf he; IriGfclll-ed C1ilL-(nCk Pool I C(vz�,C1eUC Ct►�c( a4•tr iu Muuu,undi WUFK w ue rmeu, unuei uus Pnirnu.-6TLeCK du WJA dppry: OHVAC GaSTank�ll )' C1 G J1s3 Pi p ihl LJ Shutters \i•;,, r+ Windows Electric 0 Plumbing OSprinklers E Generator DROOP' Roof pitch :V Total Sq. Ft of Construction: Q�%�� ��-7 L 5 Ft. of First Floor: •._ .�: i :•J. C• , •: •-• ' Cost of Construction:.$ I �.� y 87. 0� t - Utilities: _Sewer❑'i Septic B . &9n.g HeigNtf I •, a r. ". ! \I NilYµti. ^y i f f 'p•'• T k :...•..,...-, ("� $� },J� ("� 'd�T i 4 f4 S A IS Y6Fk'Mh Ito Pit 1 ! S� E 1 Tj� 'A �tiG©t�iTR!'�ti bL " �59,y4d, f!#iP` #.HP' A� .,'h..�n Name Name: / ! t , ' �~ ` Address: 4HOO U A1A Company: Care( Be-nhardf- /ISt R•".8 City: F4 Pier�je, cState: Zip Code: 7 R Fax: �' Phone No. 366 q33 1970 Address:77GM SW III/ City: Miami State: ry Zip Code: 3 Al S {o Fax: Phone No. 7%7- 95- ^ TOY E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail: NMAPONTLs @ 4Mt 1 L,- COM State or County License: If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. ° L1i ii:��r tGlYIriEa "vLtF�i 1, [�1.It, wk*tit �L� I�Ut LFkYY���lYtyil �, 5: �,. t.h. ..i �{[i �.'1 "*5±1: .�:-{- it iV1 ,1I11.,i ..,C5�1'{3�y.Ad�'fi lKi,,._CEf3�l�,3y, I .�`•'I i+#�Q�d vwi�1.VL :Y�. DESIGNER/ENGINEER: Name:. _ Not Applicable MORTGAGE COMPANY: Name: of Applica Address: Address: City: Zip: Ph State: City: Zip: Phone: State: FEE SIMPLE TI HOLDER: Name: ANot Applicable BONDING COMPA Name: of 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. n•1i, St. Lucie County makes no representation that is granting a permit will authorize the permit holdbr to b6ild the subject bfructure which is in conflict with any applicable Home Owners Association,rules, bylaws or and covenants that may restrict or prohibit such structure. Plew.e'consult with;yo4%Home QwhersjAssociafion and-nevi4 ywyo deed forany estric> uti�s Whrcls Shay apply. Inconsideration of the granting of this Vequested permit, I do hereby agree that I will, in Iluespepfss Pgtfoirn thSiWd k in accordance with the approved plans, the Florida Building Codes and St. Lucie tdunt}�A''ridrnents. t" The following building permit applications are exempt from undergoing alfu11 eoh urrency r6iew`'roomadaitions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory; es -to anothenrlon-resrdential use WARNING TO OWNER: Your failure to Record a Notice of Commencement fnay result in. our;paying twice for improvements to your property. A Notice of Commencement must be recorded ind iosted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencinia work or recording your Notice of Commencement. a Signatur of caner/ Lessee/Contractor as Agent for Owner Signa re of Gblffr i or/Lic4nse_K6 der ' STATE OF FLORIDA I .. /'�' ,C� 1 , . n(�� COUNTY COUNTY OF 1 1 � 1. OFORIDA (J Ll'rl(i =° The f Ing instr �n �}c�owledg efore me day 10C WT 20&by The olnin �e S cl wled a fare me this � day o v/ to , this of , Name of erson making statement Name of person ryaking statement Un Ily Known ✓OR Produced Identification ✓ Personally Known ./ OR Produced Identification✓ 3TVPe o4 Identific do Type of Identifsc—atipn, < ',•\�L I d Produced t5�.[1L< >> 0 3 0 — • . - x'o'0 ar- a N(� re of NotaryPublic-State o Florida) (Signature of Notary Public - St to of Florida ) . • : i } . u ;; l t I'(Seal)1- fj} l— No. ca� sion No Commission a .., REVIEWS FRONT ZONING SUPERVISOR LA VEGETATION SEATVft0',`MANGROVE COUNTER REVIEW .,REVIEW ;PEW REVIEW :1''6REVIEW!' ""REVIEW DATE RECEIVED DATE. CO LETED V �' Rev.8/2/17 1 U'1 /