HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO
//MUST BE COMPLETED FQRAPPLICATION TO BE ACCEPTED '
Date: " Y r O' a -k Permit Number:
l 6GANNED
BY
St. Lucie County [kKt
- -- Building Permit Applic;
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial RI
PERMIT APPLICATION FOR:
PROPOSED 1NPROUEMENT LOCATION:
Address:
Legal Des
On JUN 04 2018
a
Permitting Department
St. Lucie County, FL
.,
Property Tax ID #: 3t f Z. o4/ ) • mm. ow. (3 Lot No.
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
Mechanical _`Gaffs Tank
�lectric _Plumbing
Total Sq. Ft of Construction: ?i,r /1-
Cost of Construction: $ !Z?av
Gas Piping
_Sprinklers
_ Shutters
Generator
Sq. Ft. of First Floor:
Block No.
—Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
GONTRAC•1 OR:
1_� Ameg4. SS-4 c6G`�nCif
.Name �j')- _ et�F�I�
Address:. 9101% fr3 (mf�� Siilee� /Lifft
Name fll
�,-�_L%X1�.LC�?(Yl
�
Com,pany:. ,CfJen()b
or —
City: �CK( Q(IA - Stater �
Zip Code: -ld 10 Fax:
Phone No, I
Address: Qh_
d Gr S)C 0n
City: AJ nhQaef4A0
Zip Code: S?,(Xv� Fax:
Phone No
Stater
E-Mail: n'IUe-p-S tOSG7„]6N1^_f-axi
Fill in fee simple Tit a Holder on next page ( if different
from the Owner listed above)
E-Mail (knnec- 0 dWans
m&L4 ("'OM
State or County License C )1
20
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONST
ION LIEN LAW INF
O RMATION:
DESIGNER/ENGINEER.
Not Applicable
MORTGAGE COMPANY: Not Applicable
T
Name:
Add'ressAr ;
NN kogrye
Address:
City:
i - State: C l_
City: State:
Zip: Phone 1'>>
8a^u • &h)R21 .
Zip: Pho e:
FEE SIMPLE TITLE HOLDER:
— Not Applicable
BONDING COMPANY: Applicable
-Name:
1
_Not
Name:
Address: : . i-1 i ;C -
Address:
CO: ` _..
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 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,
accessorystructures, 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, conj�t'�v�f;h lender or an attbrrfey before
commencing work or recording your Notice of Commencement. 1 /7
Signa a of 0 ner/ ess ontractor as Agent for Owner
Sign re o onn for/Li se Holder -.
STATE OF FLORIDA
STATE OF FRID A'
COUNTY OF
COUNTY OF "
The forgoing instrument,was acknowledged before me ,
The forgoing instrument was acknowledged before me,
this 3/1' day of � 20�y
this 7^1 day of _ JUA9 20� by
AuC(f S�a
aSc
(Name of person acc nowledging)
(Name of persorl &Wowledging)
n
(Sin re of No ry Pu c-State of Florida)
(Si ure of No� ry Pub -State of Florida)
Personally Known ✓
Personally Known RDferfeoedVefeggifygp�.�_
Type ofldentification ,ram NoferyPublcSlateblFlodda
Type ofldentification =,u"•W_ NotaryPubnkSteteofFlorida
`�.
Produced Rachel Myers
Produced Rachel Myers
mission GG 18388t
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%Commission
: g ion GG 183887 t
pin Ii res.0&85f2022
Commission No.
No.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLAN
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVI
REVIEW.
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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