HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FO�e fRNWIoN TO BE ACCEPTED
Date: 3 a� BY U Permit Number:
St. Lucie County
'- RECEIVED
Building Permit Application MAR 2 S 2918
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line W I�� sS l
PROPOSED IMPROVEMENT LOCATION:
Address: 9eCO 5 • ocea.r-) brNe CAni t 403
Legal Description:
PropertyTaxlD#: t+'tDOd-
Site Plan Name:
�aM
Project Name: "(-,i I -Resi de -nice -
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Lot No.
Block No.
Remove arZd Yepl0.ce sliding Glass c7 clr
CONSTRUCTION INFORMATION: I
HVAC " Gas Tank
Electric El Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 1 i
O(3
,., rr,r.
Piping _Shutters Windows/Doors
nklers 11 Generator Roof
S Ft. of First Floor:
: _
UtilitiesSewer � Septic
Building Height:
Roof pitch
OWNER/LESSEE:
CQNTR,ACTOR.*-
_Name-RRclhP1'-I-.=-i-� I -
Name 1' Uj(�-T��►`C-lC�e, -- - -_ -=—
_"
Address'Q�f�'. t` C)(�:eQl1 l�Y �lh�i 4Q3
:Company. ME•G)Q_SS PrOkSSIOnG S
city_ State: FL
Zip Code: 34961 Fax: ��
PhoneNo. 3 - ..7Q10
Address: '2)C5 6 SF T)IXI P-
l City: �oDjC ± State: �-
Zip Code: 34CR-1 Fax:-77a In•0410L
Phone No. I-7a ^ aB(D
E-Mail: N1
I or
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail:
State or County License:
it value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
_
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
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 antl 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
commencing work or repording your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor icense Holder
STATE OF COUNTYOFORIDA
rfiog in
STATE OF
COUNTYOFORIDA YYIa►�� 1►1
The forgoing instrument was acknowledged before me
this day of Feb 201e by
The forgoing instrument was acknowledged before me
this fAl day of Tr� 20-B by
-c)�
Name of persog making statement—
Personally Known ✓ OR Produced Identification
Name of perso making statement
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of " Public -State of FJ,gWa)
�/11 '�"',,,4�, JONUIEMEERAN
Commission No. l9 6 �15 eeIr_C MMISSIGN#GG
e E%PIRES:Nwamher?S.
��Or Fti�� aoMadnw adpQNmary
(Signature of N ry Public -State of FI '
Fxvcu JGN7NEMEEMN
ommission No. `-'� rMISS�NtGGdld577
EXPIRES: NmemEer 2i, 2a10
+iF eP` eonddmwaWtelNolmYsmuke�
OF FL
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
EGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REV
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
if f7�1$
Rev.8/2/17