HomeMy WebLinkAboutBUILDING PERMIT APPLICATION• ALL APPLICABLE INF9 MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I2 ZB 2a 1 -t
SCANNED Permit Number:
BY
St. Lucie County RECEIVED
Building Permit Application
Planning and Development Services MAR 2 3 2018
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ST. Lucie County, Permitting
Phone: (772) 462-1S53 Fax: (772) 462.1578 Commercial �_ Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line `
C G
1f��ld
P�tbP�O4 l g ��4EMIrlsQG4[i0N �` i i
Address;g(ig O S �Cean Jc w e. C)r, } G to A
Legal Description: CEW—l'TOL"94 5 CorrXnA 0
Property Tax ID k:3 53 S.'?O ( - p p ({ ( -00o- 3
Lot No.
Site Plan Name:
Block No.
Project Name: _ J(h c%
Setbacks Front Back: Right Side: Left Side:
�a cge. r4 a*; ,
bEyTi Fr P �IOIV 0 `�ttORK€ '`n see,',. �; sna,
aorve,C,GuClaoc I16 117-<, SQ,
l./it
iJl.L•"Nf V;a4j*j6:
r -
°r4u.3
:t
i,
lonal worm TO be apply:
❑HVACGasTank
❑Gas Piping _Shutters ❑Windows/Doors
❑Electric
Plumbing[]Sprinklers Generator ❑ Roof
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost Construction: $ ISO?- It Utilities:llSe�werliSeptic Building Height:
��of
'
Name:
Nams>. p n ry 'ns
•s- -- -
%4�i0
Address�S ran n � f , � C+ � •� •F_ / (6 A
Company.-
_
City:13 CQCL, State: F1
Address: l A 4 tc I -7q ib (tT
Zip Code:3L195-2 Fax:
City: LL, Ei 1vrC7RE'r^,C (ram State:,_
Phone No. -937F(
Zip Code: 334I a-- Fax: _4T41 S`S•1905-
E•Mail:
Phone No. L / s-s-- el OS a
E-Mail:
Fill In fee simple Title Holder on next page (If different
from the Owner listed above)
State or County License: L 1•
If value of construction Is $2500 or more, a RECORDED Notice of Commencement Is required.
A
Name: —
Address,
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: — Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Name: _NotAppiicable
Address:
Zip: Phone:
1 certify that no work or installation has commenced prior to the Issuance of a permit.
structure.
is in conflict with any 2pplicatile Home Owners Assoc lationl rubes authorize the
antl covenants that mayd estrsubject
ct o prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions whlch 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
commenci work ootrecordinR your Notirp of r,,,... e e .
The forgoing Instrument was acknowledged before me
this QU day of De e- - 20 t_iby
Known
Revised
November 18, 2018
c
s
Signatu n r/License Holder
STAT OF FL
O n
COUNTY OF h
The fo oing instrument was acknowledge efore me
this day, of &A 1/ 20 by
(Name of person acknowledglfrJ
(51gnature otary FUJIc- State of FI da )
Personally Knowny OR Produced Identification
Type of Identification Produced
. MY COMMISSION# FF 951e69
knGW Thru 9-901 NmW, Services
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS