HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLIC LEI FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I� 20 (r SCANNED Permit Number:
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St. Lucie County
CE REED IV
Building Permit Application
APR 2 4 2018
Planning and Development Services
Building and Code Regulation Division
ST, Lucie County, Permittl^�
2300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772) 462-1553 Fax: 462-1578 Commercial Residential
(772)
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address: S.1clikt Die&, [ ac tiahih, API 10.9,.
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Legal Descrition: •S ¢ 31i11 'lCQ, t - 7:�
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Property Tax IDtt: eae.q, Lot No.
Site Plan Name: Block No.
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Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILEDUECRIPTttN:DFVIIORK �, ivy,t , „ u rs' h,
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Adclitional worK to e e orme�dun ert6ispermit=cFe`c a appy.
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�HVAC Gas7ahk Gas Piping Shutters Windows/Doors
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Electric Plumbing []Sprinklers LJGenerator Roof Roof pitch
Total Sq. Ft of Construction:,, II ^^ S Ft. of First Floor:
11Sewer []Septic
Cost of Construction:$ 'l�l%V Utilities'Building Height:
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Name_ I�D%iLk7 2-AJ
Name _ zC/1h
Company: 12
Address:
City: 'aate:_
Address: Grf� 3'STh'lPli^^`` r
Zip Code: Fax:
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City: _1'11?,1Gd - State:
Phone No.
Zip Code: �3 0/2. Fax: 5,05'49- 0i 47
E-Mail:
Phone No. 30S' P 92
Fill in fee simple Title Holder on next page ( if different
E-Mail: L? A d c3 ( u)R am.
State or County Lice :1% 06 O Lf-
from the owner listed above)
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 TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
Not Applicable
Name:
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. ''
St. Lucie County, makes no rem� %, Zation'hTa s gfatiikniha 178- rrry�,00i rizatjte'd�rm�iA4 der t6,&&&bzsWb' ucture
which is ing 1 ict with any appy le Willie n S_Ass'sociation r les, N�j; or anBcgvenants that ay restrict or pro ibit such
)�i7�i� rye ��S?Pc"ih' 3�sP�gTO��n1e IYt1'I�e�strt� Vjir� may. apply.
Inconsideration of the granting o this reque ted permit, I o hereby agree that I will, in afl�espects,j�erform the Ark
in accordance with the approved plans, the Florida Building Codes and St. Lucie County,&Adnclrn R ll�C
The following building permit applications are exempt from undergoing a WNoggyrc43myjMvieW'.-:-i rn'�cO)Otns,
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 rpm rgsul in yourggyjpg twice for
improvements to your property. A Notice of Commencement must be c r d a 06stLtTon the jobsite
before the first inspection. If you intend to obtain financing, consult ith lender or an attorney before
commencing work or recording our Notice of Commencement.
ignatureof caner/ ee/ContractorasfigentforOwner,'•'`•Signatureof.
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STATE'OF-FLO
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COUNTYOF
COUNTY OF
The forgoing instru ent as acknowledged before me
The far oing instr ment was acknowledgec�efore me
7
this',S day of D i1 .201,� by
this daayof'Rl 20 by
7 Name of person making statement
Name of p on making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced f
Produced
(Signs ure of Notary Public- State of Florida )
(Sign ure of otaryu lic- State of Florida }
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REVIEWS
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SUPERVISOR
PLANS
COUNTER
REVIEW
REVIEW
REVIEWREVIEW
DATE
"?ANGROVE
RECEIVED
DATE
COMPLETED
Rev.8/2/17