HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED qq /
Date: �' �� Permit Number:
COL1[VTY
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Sr
BY
cie County
13MIlwing Permit Application
FEB 15 2018
Commercial <. Residential
PERMIT APPLICATION FOR: ZN j �R p� er o (u!
PROPOSED INPROUEMENT LOCATION:
Address: '705� /Jt, 39-77-1� gkeeT� XaJ2T R2Te- TL
Legal Description: L1rL12J C,T1 OS 3S-40 TNs.; P4r— p r j n® %
I DS ANC rA , rL,YG-E R. rate g-d
Property Tax ID #: al `"t D T (.0$ of 6le p ! 0 Lot No.
Site Plan Name: Block No.
Project Name: •NorC)rI-t*-cli -br15o1 nri_,
_ c
Setbacks Front Sq• 43 Back: -3 ft� Right Side: �D- I b Left Side: 3�
CrVTR�Y
[Mechanical _Gas Tank Gas Piping F,_Shutters —Windows/Doors
Electric2Jumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: t�l� Sq. Ft. of First Floor: 35
Cost of Construction: $ �./i*o06 ,�'-I—% Utilities: _;Sewer _Septic Building Height:
r ,
OWNER/LESSEE:
CONTRACTOR:
-Name- :3 -!2
Name: —737 Urc 1-P
Address: 94,0 z17 f7�`' 4✓E-
Company: - %lam {Rccl-f �E2CTor
Y
City: VeAD 14- State:%
Zip Code: 3064e� Fax:
Phone No. i 79-- V 7)-- (!os/
Address: 73510 C6~4-44,%L
Cr2
City: ��R'erCe-
Zip Code: 3 *g5R 1 Fax: 416S�a�a
Phone No ` 105- 67-7 of
State:- —)5,4
E-Mail: q/ya1yiJ7 6 Be!/S0✓77fo.J-27�
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail !%pM %nJGf Ttf�i crc{� ��C?r y �CaM_
State or County License Coc (a� 6�✓�%
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL GONSITIN ION LIEN LAW INFORMAT
01V:
DESIGNER/ENGINEER: _ Not Applicable
Name:7e-45"dp— C1VGA.oee/1S
MORTGAGE COMPANY: _ Not Applicable
Namei
Address: 14,265• bo-k*' t f
Address:
City: ✓e000 BEAe u State:
City: State:
Zip: 319t i Phoneo;L—Beed
Zip: Phone:
FEE SIMPLE,TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
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 requestedpermit, ['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
commencingwork or recordingour Notice of Commencement.
S• natur of Owner/ Lessee/Contractor as Agent for Owner
S gnat a of Contractor/License Holder
S E OF FLORIDA
COUNTY OF
The forgoing inst"uripent was acknowledged before me
this j, .day of , 20f� by ��
e
eye
STATE OF FLORIDA
UNTY OF
e e forgoing instru ent was acknowledge efore m R a
is day of , 20LV by ode
Name of person makin atement.
Personally Known OR Produced Identification
ru
g� �°
g
E
me of person making statement. g
rsonally Known OR Produced Identificatio
Type of Identification
Produced
y;y
,
pe of Identification s a
duced
(Signature of ary Public- State of Florida
(Signature of N tPry Public- State of Flori a )
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REV EW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.