HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 'd,3vqPermit Number.
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RECEIVED
BuildirwRama[it Application MAR 2 3 ?018
Planning and Development Services BY
Building and Code Regulation Division St. Lucie County ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462- 8 Commercial >— Residential
PERMIT APPLI
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1PROPOSE-
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Address: qd PL
Legal Description: LAAcE wr) UAay_- UN IT 19 -A, 1C 114LOTS 1913 1A POND
20 t'MAP 13 Zq - (Oft 1-75W - 12q-11
Property Tax ID #: _ 1zoj CO-1 Cl - Ord n/Q Lot No. g
Site Plan Name: Block No. 1�1i
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTiON`OF WORK `" `£ -' w ° �'
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CO �R`UCTIO.'INfORI CATION
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wor e e orme un er t is permit -c ec a apply;
11H JGasTank
C �GasPiping _Shutters Windows/Doors
Electric ElPlumbing Sprinklers Generator ❑ Roof
Roof pitch
Total Sq. Ft of Construction: ScFt. of First Floor:
Cost of Construction: $ �' Utilities:Sewer Septic Building Height:
OWNER/LESSEE r t ""{CONTRACTOR
NameLaket_ cid
ParkName:
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Andress: 8 - - — 1
Company: rYt }ii
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City: CQ02State:
Address: 14SW KW Llt"+ F ke
Zip Code: Fax: qW- L4'Ji_2_-
City: &Unri5t✓ Stater
Phone No. y- 2 - 02'I
Zip Code: 55?25 Fax: Q4 t - 851 - (Be 3
E-Mail: AS r Q rFii i LU CO
Phone No. - Rcl - 1300
Fill in feesimpleTitle Holder on next ge (if different
E-Mail:
from the Owner listed above)
State oy_C�ourjLti License: C r 1_P)2
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If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER:
_Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
Name:
_
Address:
Address:
City:
State:
City:
State:
Zip: Phone
Zip:
Phone:
FEE SIMPLE TITLEHOLDER:
_ Not Applicable
BONDING COMPANY:
Applicable
Name:
Name:
_Not
Address:
Address:
City:
City:
ZIP: Phone:
Zip:
Phone:
vwrycril CONTRA RAC I OR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that nt�oo( work or installation has commenced prior to the issuance of a permit.
which is In conrll makes no
any applicable (Home Owners tAssociationl rules authorize
bylaws or and 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
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Signature
Owner I Signature
I =/
STATE OF FLORIPA STATE OF FLORIDA
COUNTY OF A.c>L'Ja_10 COUNTY OF_ � i/+
The forgoing instrument was acknowledged before me The f oing instru��pt was acknowledge before me
this i> day of M141-Cw 20� by thist� day of �/ Jd r r° L . 204L by
ame of per' s6n making statement erson making staff ent
Personally Known OR Produced Identification Personally Known OR Produced Identification _
Type of Identification Type or IcIentification
Produced Produced
(Signature of Notary Public- State of Flo Ida I
2020 It 1 11--An •a; EXPIRES: February 24,2022
FRONT I ZONING I SUPERVISOR I PLANS VEGETATION I SEATURTLE I MANGROVE
COUNTER RFVIEWr�l REVIEW REV[ REVIEW REVIEW I REVIEW
Rev.8/2/17