HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUSTBECOMFLc i cD FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
�fjUr�aO 61-
r;,, �8 JJ7 Is .....RECEIVED
• @3�NbO5` FEB 2 3 1018
Building Permit Application Permitting Depart,
Planning and Development Services , St. Lucie counh
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:
Address: %/'59
Legal Description:
^,P roperty;Ta a 13D 1 l � �� &D —00 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
3
Aaa¢ionai worKto oe perrormea unaer tnis permit- cnecrc au Lnat appry:!
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Mechanical _ Gas Tank _ Gas Piping _'Shutters _ Windows/Doors
✓Electric' _ Plumbing Sprinklers
/—Sprinklers ?"Generator _ Roof Pitch
Total Sq. Ft of Construction: g, L o Sq. Ft. of First Floor: '2
Cost of Construction: $ 10 6'0. o0 Utilities: —Sewer —Septic Building Height:
RA(TOR
iv
Name
Name: Jzti t +3 d��Ntd ^
Address:
Company: t$ T c
City: G State:_
Zip Code: 3� Fax:
Phone No. 1-7Z - -? 3
Address:
City: G /e LDS -d State: --a
Zip Code: 72!2:Ej� Fax:
Phone No 7-2-2 4'o
E-Mail: Zlygzeeo 2 {^ o'X�
Fill in fee gimple Title Holder on next page ( if different
from the Owner listed above)
E-Mail h w 71-1�n K R ya m i C6yy
State or County License F-i 136 A��W
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
- iYaRZtl
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.
'ln;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
cornmenoing work or r rding your Notice of Commencement.
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ature of Owner/ Lessee/Contractor as Age
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S' n ture of Contractor/L�cense Holder
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The instrument was acknowledged be
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The forgoing instruient was acknowledged befo
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this day of Fe VJ 20�Vb
this 23 day of VeAo 20�by
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(Name of person acknowledging)
(Name of person acknowledging)
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a ` "_ e �'�/ re_�f/lire z Lea-.
(Signature of Wtary Public -State of Florida) Ll
(Signature of Notaky Public -State of Florida)
Personally Known OR Produced Identification
Personally. Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced t>. L-
Commission No.. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.