HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO f LIST fSE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _3 \ SCANNED Permit Number. \�d3�OSaG,
=' BY RECEIVED
St. Lucie County • -
Building Permit.Applicath in MAR 19 2018
•Pionning and Development Services
Building and Code'Regulanon Division ST. Lucie County, Permitting
2300 Virginro 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 lae - -ill
Legal Description:
,...i.'.. - u —r0 17
Property Tax lD #: 07 31V -old - t? J ) I ! o o J - Z. Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back:. Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: ill
74ls
iC']HVAC ❑Gas Tank ❑Gas Piping ❑_Shutters ❑Windows/Doors
(_jElectric 11 Plumbing ❑Sprinklers Generator ' ❑ Roof Roof pitch
Total Sq. Ft of Construction: :�- t tom5 Ft. of First Floor: % I/i t /
Cost of Construction:$ «r tzr�-0 . UtilitiestSewer 0Septic Building Height Itl
OWNER/LESSEE:
CONTRACTOR:
Name el:r 1.
Name: TIND tiP ow P J La
Company: -f w
Address: `(.hi �(• % ..
Address: al, C1 <n a!J J ry
Clty.�LXCk n, «. State:!
ZlpCode: 349YC Fax:
Phone No: _ - -- - - - _
Cky: 5� Ll Stater
66-Eode: `33Sj•- Fax:-
Phone No. r-D 1 D
E-Mall: t rlk'S a 9 n cant,
E-Maw:
Fill In fee simple Title Holder on next pagg (If dI ferent
from the Owner listed above)
State or County License: G&Y-r V "3R 1� ,
01 a a25w aF more, a RECORDED notice of commencement is required.
'SUPPLEMENTAL CONSTRUCTiONLIEN LAW INFORMATION:
DESIGNER ENGINEER: _ of Applicable
Name: h f r4
MORTGAGE Cff PANY: of Applicable
Name: -
Address:
Address:
City: State: _
Zip: Phone
City: State:_
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: -:5 of Applicable
Name:
Name: �?
Address
Address:
City.
Zip: Phone: '
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do tho work and installation as Indicated.
I certify.that no work or installation has commenced prior to the issuance of a permit.
the ermit holdego build the subject structure
r an9covenants trtat may restrict or prohibit such
led 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 followingbuildingpermit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen roams and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice
Improvements to your property. A Notice of Commet
before the first inspection. If you intend to obtain fin
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF G' , A
Theforgoinginstrument was acknowledged before me
this ;s. day of Me?ee- .20 i5by
Name of person making statement /
Personally Known OR Produced Identification V
Type of idetl[+firatton
Produced
(Signature,ofON M
It.SeaNEIe
Commissional ML'N
61iP¢t69 ---rPW43att
Ausi M IT, 2dt9
REVIEWS - - FRONT ZONING
-- = - - COUNTER-1 REVIEW
mencement may result In your paying twice for
t must be recorded and posted on the jobsite
consult with lender oran attorney before
Signature of vn mclor/License Holder
STATE OF FLORIDA n
i COUNTY OF Ilnay.X
1 The fo Ding instrument was acknowledgedkefore me
this day of )'Acu-L, . 20— by
J Z�eh cz�t :Q�
Name of person ing statement
Personalty Known OR Produced identification
Type of Identification
Produced -
{Seal)
IN I SEATURTLE I MANGROVE
1---REVIEW - -_REVIEW- -