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Home My WebLink AboutBUILDING PERMIT APPLICATIONI All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: C�L' Permit Number: JCANNED 8Y Lucie County EFEB D Building Permit Applicatio18 Planning and Development ServicesBuilding and Code Regulation Division ermitting 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: Address: (U%tW- Legal Description: PropertyTaxlD#: Site Plan Name: Project Name: Setbacks Front Back: • t 111 hrll Right Side: Left Side: Lot No. Block No. <DETAIt EDIDESCR(PTION" F i VO K " ' "' �. x .n IIZE I �T&- S i J CCD �IS�-1 N b La L- L !i IA'1 U �' 4 I V1 to C5t(.EVL w©©� rE w-►- �� rivaiclonai worK co oe perlormeu unuer mis permit- cnecK all mat apply: _Mechanical GaS.Tank _Gas Piping _Shutters -'Windows/Doors': _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ - 1ocy. 0,9 Utilities: :j_, Sewer _ Septic Building Height: aOWNER/LESSEE:4g; CONTRACTOR: q' Name G} d'F-t: =EMT LAr4D' IAI✓t65 It4 Name: TA A-IeV--,$111Wa0 Address: -PO BOX -40S_Y Company: /16 City: State: JV�' Zip Code: 9qS Fax: Phone No. Address: -lco State:_ Zip Code: Fax: "I 1233�241� Phone No -7 2 y0ej (�3i / E-Mail: EV*t4e Ncl SOLrr ig CIoM Fill in fee simple Title Holder on next page ( if different - from the Owner listed above) --I E-Mail -T- eL U124�;;/_0q>4SS-M�i wb State or County License ► (;? 5q °` If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address:.-, I :-, Address: City: State: City: State: Zip: _ Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Nan' e: " .-'_ I Name: Address: Address: Zip: Phone: I Zip: 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 1 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 use`s 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 bef�ecorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult ith lender or an attorney before commencing woulkor recor ngvour Notice of Commencement. % Signature of wryer/ Lessee/Contractor as Agent for Owner Signature ol++Contractor/License Holder -STATE OF FLORIDA STATE OF FLORIDA I COUNTY OF (t.lN, COUNTY OF. 1.1�17,1F. The forgoing instruryent was acknowledgebefore me this Tr day of_. 20 by The fgsgoing instru s acknowledged efore me this day 204 by migey" mew of �fid- riv►�cy (Name of persona nowledgi g) CJ (Name of person acknow edging ) (Signature of Notary Public- St .; K A R E N S. N I E L S ature of Notary' Public- E N KAREN S. NIELSEN , Commission # F 115 Personally Known OR VerAT194tifn e; 37 om, fission # FF 1 563 nally Known 0 d 1 pi Ayer _li o 41} ti{�i o' xpi,es Type of Ident' ion ` .tune 12, 2018 Typ of Identificati .;; 2018 o,... .tune 12, Produced C' ced (. L Commission No. saga. uoissiw(�eal�w ` :. Commission No. 9L0i'zleunp (5 _ LE951 L dd # uo1 ssiwwoz se,i x3 umss,:WUn Aw S131N 'S N321tlN '"�01" Lf951 L dd # uoissiwwo� = z , „�,.- REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION MANGROVE SEA TURTLE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE p� RECEIVED •�,��0 DATE COMPLETED Kev. //ZU14