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HomeMy WebLinkAboutBLUIDING PERMIT APPLICATION-_ ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: SCANNED Permit Number: 1= 1 By St. Lucie County Building.Permit.Applicaiion Planning and Development Services MAR 1' 4 2018 Building and Code -Regulation Division 2300 Vkginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553. Fax: (7.72)462-1578. Commercial. ✓ Residential. .PERMIT APPLICATION" FOR: To Select from dropbox, click:arrow at the end of line . PROPOSED'IMP.,ROVEIVIENT�©CATION.-r� �?. .: �� Address:'_5f)l5Y7 :Legal Description: 1 nQ kkA V'M 4)'(4NC oceaA 7r, Property Tax ID.#: -2-5 ©oc)O 0CC> U. Lot No. Site:Plan Names 2 2 Block No: Project Name: -. I f\� jiCIVkM OY\�0C20.n C_utl O Setbacks :Front Back: Right'Side: Left: Side:. DETAILEDDESCRIP.TION„OF WORK ,Sj 161-7 6191 11 (Z CONSTRUCT�IO,N' NFO_RI1%IgtTlO�N `y a` ' 1 `+ ? , _. ' t iUona wor to a e_ orme un er.tis.permi -n ec a appy:, I IHVAC � Gas Tank Gas Piping _ Shutters Windows/Doors Electric .: ElPlumbing Sprinklers Generator Roof Roofpitch TotaLSq.FfofConstruction: S Ft:of.First:Floot: Cost.bf Construction: $' �O'ooD: on Utiiitles:Usewer Septic Building Height: OWNER/LESSEE: - C©LNTRA'CTOR: Name — =Name•V 1�Addres CompaOYl-` 52f. I%e5.City:, rt b Qv� State: f_L Code: Fax: Phone No.. _ �o.. AddresZip City: State: Zip Code: �53-O Z:) Fax: Phone No. 51P 1 -77 2 OZ. E-Mail: - Fill. in fee simple Title Holderon next page.( f different .from the Owner listed above) E-Mail• of m 45 jD tk),5 i • ri state or C unto y License: C &Cl $b (o % 37 IIIf value of construction Is $2S00 or more, a RECORDED Notice of Commencement is.required:: 06. , 0 II SUPPLEMENTAL CONSTRUCTION LIEN LAW, INFORMATION: DESIGN ENGINEER;. Name: _ -Lby Not Applicable MORTGAGE COMPANY: Not Applicable Name: Address.4Z, W OcQn- Address: City:fb Zip: Phoneme-ra. State:�FL - ZO- 460l City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Name: Applicable BONDING COMPANY: _Not Applicable 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. no the permit holder to'build the subject structure r anscovenants 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, accessorystructures, 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 Com!mencerngRtlffiiaresult in your paying twice for improvements to your operty. A Notice of Commencement mu a reco ded and posted on the jobsite before the fnspetlog. If you intend to. obtain financing, cop&lt with I der or an attorney before commencing w or re 7dinahfitur Notice of Commenceme -: (nal tgnature f Own Le a/Con actor as Agent for Owner - i Co ractor/License Holder STATE OF OR A ST OF FLORIDA COUNTY F O rn t op C UNTY OF QA14, Y6WJ, The forgoing instrument was acknowledged before me this dl'"-dday of 2b by The forging instrument was acknowledged before me this Mayof Aet 8 jd,n� 20 f5 by cY( r^QS' �iGi��o — j JT-r' s C 0lid of person making statement P sonal own r/ OR Produced Identification a of person making statement P sonal Know �� OR Produced Identificati _ T Identificati Produced r° +""'••, - 7RACYWHITMAN y5 'r,; flYCtil ISSIONitIF907567 6, 2019 Type enti icatio ProducediaSlONftFF907567 .; -`- ' EXPiFtES: Augusl6, 2019 '!„ EXPiRES:August /n1 tt Dcnd6d Thry Notey Pubeundcm"titer Rf d'„•- 9ondgdThNNotaryPubru:undMW1ters t (Signature of Notary Public -State of Florida I (Signs re of Notary Public- State of Florida j -Corrfmission=No. - _ _ - _(Seal). Commission Noy- - -{Seal)= - - , REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17 /