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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Feb • 13 , 5018 SCANNED Permit Number: BY St. Lucie County vacevev Building Permit Application MAR �� 10 Planning and Development Services 'tMent Building and Code Regulation Division/ ntttln90 Cow 2300 Virginia Avenue, Fort Pierce FL 34982 / St, Lucie Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial V Residential PERMIT APPLICATION FOR: Fe_(-)cj� PROPOSED IMPROVEMENT LOCATION: :iN-- Legal Description Address: 4'� yL4ye.. 112 35 39 S W 1/4 OF SE 1/4 OF NE 1/4 - LESS W 25 FT AND _ LESS BEG AT PT OF INT OF N R/W ORANGE AV EXT Legal Description: AND E LI OF SW 1/4 OF SE 1/4 OF NE 1/4, TH W 265.64 FT, ' TH N 646.72 FT, TH E 266 FT, TH S 646.72 FT TO POB AND LESS 1-95 R/W AS IN OR 246-2378 (5.40 AC) (OR 2612- _ Property Tax ID#:3(�' I'4?,'(X��'CDCDy 8 2072:2858-375)_ LOLlVO. - Site Plan Name: Block No. Project Name.-- Setbacks Front Back: .Qi7f� Right Side:_ Left Side: )© I DETAILED DESCRIPTION OF WORK: _ c* Qo' L,01 t5�Wb wltre CONSTRUCTION INFORMATION: AaClitional work ❑HVAC to e e orme under tispermit-c ec �GasTank ❑Gas Piping a apply: ❑Windows/Doors _Shutters. ❑Electric El Plumbing ❑Sprinklers ❑Generator ❑Roof = Roof pitch Total Sq. Ft of Construction: Q S Ft. of First Floor: Cost of Construction: $ 6 t� C�� U� Utilities:Sewer []Septic Building Height: OWNER/LESSEE: -- _ ._. CONTRACTOR:, Name 01& Name: -P_ l� Address: -.3 Eiv—��bOta� 14�e Qt Company: t<.AS Ff(-lC _ COC City: RX+ ReiCe M. d, State: F- Zip Code: a1�149lLA9 Fax: Phone No. 2�� CcDr­4CE{vY� Address:A. 3?-'G "� C- .TG e.(.4V1 8{ • City: Zip Code: PhoneNllo. gcla' ago' State: �t Fax: 1015 (06 .1;g283 E-Mail: Sew- 0L-A-)4-rc?C_+Qir- Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail: Rey-nasf5 @ 0an;(-lSFe gee- , corn State or County License: If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Name: _ Not Applicable MORTGAGE COMPANY: Name: _ Not Applicable Address: Address: City: Zip: Phone State: City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: 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 ancl 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 recording o No 'ce of Commencement. � K aw C Signature of Owner/ Lessee/ ntractor as en for Owner a Signture of Co tractor/License Holder STATE OF FLORIDA () STATE OF FLORIDA COUNTY OF () t�-e_ COUNTY OF iY) f'•I-Ir1 The fPr�,RIng instr ent w acknowledged efore me The for oing instrument was acknowledged before lr this W dayofmarra .20Vby this dayof_ 20IS by 4 Z o Name of pets n making statement Name of personyaking statement w A N Personally Known V OR Produced Identification Personally Known ✓ OR Produced Identif catio Type of Identification Type of Identification z Produced Produced z a' E i E o N,a 17. O � 2 (Signature of tary. ublic- Stat Flo_ d_a) bh -State of Ftbkida) (Signature of Notary P" Commission No. I (Seal) Commission No. 1�� 5 I I I8 (Seal) =? x ^'KiY"• MEGAN LONGCORE $�= Commission # FF 919015 jr Expires September 16, R SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17