HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: of ' I� • �A�Per�® Number: 0 �� ' C' � ( .
BY
St. Lucie County
- Building Permit Application FEB 112018
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 Residential
PERMIT APPLICATION FOR: d2-e "oA I2
Address:
Legal Description:
Property Tax ID #: `1 III ' Sl/,-O)18'Df.IID _ Lot No.
Site Plan Name: Block No.
Proiect Name:
Setbacks Front Back: Right Side: Left Side:
—Mechanical
�/ Electric
_ Gas Tank
-/Plumbing
Total Sq. Ft of Construction: < • . -
Cost of Construction: $ I D OD
Gas'Piping
Sprinklers
_ Shutters
Generator
Sq. Ft. of First Floor:
-Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
®W /LESSEE:
G 0NTRACRTOR:
Name (3a�'n f CPS zl` ,1
,:Name:'O�li� C
Address:1OC60 5. -C-D e-ectn 9p I��o
Company,:>c,FUc`57 D,,U'=0A15 Ni
city: -Ten 4� a Gc State:FUl.
Zip Code: 3 `f qS7 Fax:
Phone No. 9 7'z - O qG Y
`Aiidressrl0{ '.$ . B i iifiuldEC`f
City:"'you " i�GUGic ^ State: �L
Zip Code: Fax:
Phone No 722) 7aV-/3�a y
E-Mail: L• S�I 1.07 Lo— A-CL cf pcn
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
_
State or County License C(;e /L5'/YaozoZ
If value of construction is 2500 or more, a RECORDED Notice of Commencement is regwrea.
S E-MENTi *ONS U � IOf� LIE... lAW tNF(ORMATlONs
DESIGNER/ENGINEER: Not Applicable
Name: —
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to b6tain'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;lierebyagreethat 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 con,currency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory dsesko 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 work or recording your Notice of Commencement.
Signature o ner/ Lessee/Contractocas Agent'for;Owner
STATE OF.FLORIDA J STATE OF. FLORIDA
COUNTY OF _<2 . LLB C i,,Z_ I COUNTY OF 3
The forgoing instrument was acknowledged before me The forgoing instr ent was acknowledgged before me
this day of'. 2019 by this1� dayof � 2011 by
gUrlice 2_a9,1 � i V � ttck dltN0e.5
(Name of person acknowledging) (Name of person acknowledging )
L&t2• ,e2Z�
(Signature of Notary Public- State of Florida )
Personally Known L- OR Produced Identification
Type of Identification
Commission'No0 600616 J
REVIEWS FRONT ZONING _
COUNTER REVIEW
(Signature of NotarV Public- State of Florida )
Personally
Type oflde
2020
SUPERVISOR I PLANS
REVIEW REVIEW
OR Produced Identification
n,^^.."
DEANNAMARIE GNENS
:c; y.. SI0!!;7e 022023
f?(PI� RES: December 56.20
ki Notary Public (ld.� ew
VEGETATION
SEATURTLE
MANGROVE
REVIEW
REVIEW
REVIEW
DATE
)
/S
RECEIVED
/
DATE..
COMPLETED
ev.
mA
W //