HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLEi 6 FOR APPLICATION TO BE ACCEPTED
Date: ?/W a Permit Number: '_D2.
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address:W2_- 310)2
Legal Description: Me
Cer'1 C Sqd-(, RECEIVED
Building Permit Application FEB 21 2018
ST. woo
Cvunty, Pern
a
14
Commercial Oan; ffiesiclential
Property Tax ID
Site Plan Name: No_xonc_ �")p Block No.
Project Name: ? a n .0
Setbacks Front Back: Right Side: Left Side:
✓Mechanical Gas Tank —Gas Piping —Shutters Windows/Doors
V Electric Rlumbing �',/—Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: �TQ/ S Sq. Ft. of First Floor:
Cost of Construction: i Utilities: — —Septic Septic Building Height:
�_ i /
OWNER
LESSEE: _
CONTRACTO.R:
.Name ( 5.
`
_.
Name:—
_—
Addre�ss�: Co r,25S Avg -t~ 1
Company�G ,, �AJaoAS /JetoC-
c2�52
City: W2Jl �o. Nl . 9C.0 State:_'rf
Zip Code: 3340(D Fax::5W b41 rA71
Phone No. 561 (o4 I aOO 2-0
Address1: �70rJ S, L�,aa�( c .
City: VA . }�, &A-t -e- State:
Zip Code: 3y �1 SFax:
Phone No i a sat 1130
E-mail: _Q` Q pYz r a COS . Co,n
Fill in fee simple Title Holder on next page ( if different
from the owner listed above)
E-Mail We,& 9 `�) 04 .(oiv\
State or County License C8c 05L10 3
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
SUPPlEME1VTALCOIVSTR
TIOf LIEN LAW
INFORMATIQN
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address: T--," ,— `
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:'-
_ Not Applicable
BONDING COMPANY:
Name:
_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 OWNE Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to yofirbroperty. A Notice of Commencement must be recorded and posted on the jobsite
before th rs i pe ion. If you intend to obtain financing, consult with lender or an attorney before
of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FIL 2
COUNTY OF I q fV-1
The f oing instr e t was acknowledged before me
this T day of & by
STATE OF FLO IAA
COUNTY OF �D JlM
The forgoing mstruMet was acknowledged before me
this day
of N - wl
U ZDJI-by
(Sig'nafure of Notary Public tate of Florida) (Signat—ure of N ary ,ublic- tate of Florida )
Personally Known 7 OR Produced Identification Personally Known t OR Produced Identification
Type of Identification Type of Identification
Produced 77-7, ;•, DANIELLE A. RoWAILLE Produced
"�o�"•' DANIELLEXROWAILLE
COMMISSION # GG 077751 :� 'y MY COMMISSION # GG 077751
0- PIR S:June 25, 2021
Com sion Na <o••,g",'' B'gAI, p, u Com issi n No. p4 ( B S;June28,2021
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER EVIEVy REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETED