HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: I(1 ' ISCANNED Permit Number: 1 n
� J
B
St. Lucie County
RECEIVED
0
Building Permit Application OCT 2 6 2017
Planning and Development Services
Building and Code Regulation Division PER^ ' -
2300 Virginia Avenue, Fort Pierce FL34982 St. L �e Counh•, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR:%ge—Mo(i on"5*
Address:
Legal Description:
Property Tax ID #:
Site Plan Name: tf f-)DQ07ra
Project Name:
Setbacks Fr
\}
Back: Right Side:
5M5 +OInlc , Oc 0c U Y)CSLe- C rn6
0 Plumbing
Total Sq. Ft of Construction: t� f
Cost of Construction: $ 4qb I U:1
Left Side:
Lot No.
Block No.
�ttz�t-� U'CVYICa�e
-5�
Piping
[is hutters
Windows/Doors
nklers
0 Generator
El
Roof
=
Roof pitch
S(7I —F—t.� of First Floor: _
Utilities:cnSewer OSeptic
Building Height:
°'
OWN to
Name
Name:
Address: M
Company:
City:<A�J17G�i t4- Stater
Zip Code: l-iG Fax: '1Q- 3 A -U (P q
Phone No. - -
Address:
�(� �N V
l
ity: -ttn )CY? 4 Stateg
Zip Code: Fax:-ii ri
hone No. ? Aq b
\V. U�
E-Mail:-eA,0-6a i-:bP(-QR ne-%v�
.. _.
Fill in fee simple Holder A next pag.d if dt Brent
from the Owner listed above)
E-Mail
State or County License: i )�:o
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
_ Not Applicame MORTGAGE COMPANY: _ Not Applicable
Name:
Name:_
Address:
Address:
City:
State:
City: _
Zip: Phone
Zip:
FEE SIMPLE TITLE HOLDER: _ Not Applicable I BONDING COMPANY: _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 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 property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing wofkor retsoxdipg Vb;.wAotice of Commencement. / �? /1)(?
1 'All � A��
Af�
Signatur70
e of Owner/ Lessee/Contractor as Agent for Owner
Signa u of Contractor/L
en a Hq der
STATE OF FLOUNTY OFORIDASA— �- (—( e—
C LINTY OFSTATE OF ORID
�1-
L.lCA, 2.
The fo oing instrume-�rqites� s acknowledged efore me
May E7C'.t VDe_r
The forgoing instrument
as acknowledge before me
this of . 20Jby
this J,Qday of l\�.
20by
Name of person ing statement
Name of persona Ing statement
Personally Known OR Produced Identification
Personally Known
OR Produced Identification
Type of Identification
Type of Identification
Produced
hw)aem We mn
Produced
hAiin(Signature
of Notary Public- State of Flori
of Notary Public„.('"�:.e,BARBARA�N
°q, BARBARA WAT,9(,Commission
No.TI +° Il #on
/'-�,
No.'i—t'
!De
•
1�56%1'+]'dMISSIdN #FF15Pi'�:
y COMMISSION
a EXPIRES August
'ipo�y�dF°EXPIRES August 28,21
IoridallotarySeN
40710ga•016I FlorldaNateryServlce.con
REVIEWS
FRONT
l
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17