HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED '1
Date:' a l (I is SCANNED
Permit Number: 1 �seia — i�id
BY
• St. Lucie County RECEIVED
Building Permit Application FEB, 13 2018
Planning and Development Services
Building and Code Regulation Divisist. Lucie Permitting Department
St. Wcte County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Window/door 1-1 1
I PROPOSED" IMPROVEMENT LOCATION: III
. �- � :� • l •act �.��� ■ ��a• ► ••
Property Tax ID #: 450a- 503- 0.155 - 0CQ -
Site Plan Name:
Project Name:- . Oppi f 'R� dencr-_
Setbacks
Back: Right Side: Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK -
�Rermorc C-nd replace. 08) sliding class door-5
and C3-) SiIZgle hung WindowS w/ irn0ac+-
CONSTRUCTION INFORMATION:
OHVAC LJGas Tank
11 Electric 0 Plumbing
Piping "Shutters
!rs IJ Generator
,IS'. ii.i.,.61"Firs�'Floor: _
Utilities:- ;Sewerbeptic
i n i Windows/Doors
E]Roof Roof pitch
Building Height:
OWNER/LESSEE: ;; s
CONTRACTOR:
Name Eriwai i. sharrin mror-e -
-Name:
-iAddress �i �lne Grove C_CrCIe
`Company:�Q:blaS$ � SSID�S
Gty,FA$.. �pYl�e(1(irit 1 State:A�A
Zip Code:ll I Ga13 Fax: N I A-
Phone No.
'Address ?251D SE
DIXI-e M_
City: f5A1� Stater
Zip Code: �4991 r!�z Fax: -71Z _2610
Phone No. ZV10 OL4 5
E-Mail:_ N
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:
FLfY1/11 i .s, 9
I ass
Frog
Mo
_dQ
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
'SUPPLEMENTAL CONSTRUCTION LIEN LAW. -INFORMATION:
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 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
comn_lerZing work or recording our Notice of Commencement.
_
w
Signature of Owner/ Le ontractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA Ivy
STATE OF FLORIDA
'� ,
COUNTY OF 1 ► U111 t,l Yi
COUNTY OF � )
The forgoing instrumen was acknowledgel before me
The fg oing instru ent was acknowledge before me
this � day of [ . 20M by
this 1_ day of Q . 20 by
VYC4C)Z
f`�Ot V 1d LovprGICp
Name of person making statement
Name of pp on making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identificatiorf
EMF�/i�
Type of Identificati n
Produced �'41�II
Produced ����p"pNNE/11!i���
cp
(' ature of Notary Public -State of Flor@a
1; @nailjA of Notary Public -State of Flc$ida.
ZC) : m OG0029517
Commission No. `' /�/S� I -
* / -'� 1''7
QC_IhmissionNo.l7ti� f $'1�,2�•
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B<iC, STATE 0
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17