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Home My WebLink AboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 3 • ►s S��®� SCANNED ` Permit Number: r.r� r .Y BY St. Lucie County RECEIVED Building Permit Application APR 0 3 2018 Planning and Development Services Building and Code Regulation Division ST• Lucie County, Permitting 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROP,QSEDIMPROUEIVIENTLOCATION w "' w E, u Address: _Y15 E. Pf ina Vjs b OJOa1a.V2ycJ Legal Description: Property Tax ID #: W� I9 SISODO o1,000o Lot No. Site Plan Name: Project Name: _AUytOGOC�4S ?,ikeS Setbacks Front Back: Right Side: Left Side: Block No. Re-&Z-VIJC `exl4tc�q �tflout sicftn 1Ne` \•� t�� nP�i dic1;,��q� TS r1tzs.T ce-C(r.ar v_ `-TMe. \`OGLt'�+O c�l�l Ce,YNaiIA Sav�+a.. ❑HVAC ❑ Gas Tank ❑Gas Piping ❑_ Shutters ❑ Windows/Doors ❑ Electric 0 Plumbing ❑Sprinklers ❑ Generator ❑ Roof Roof pitch Total Sq. Ft of Construction: i 2 S Ft. of First Floor: a Pc Cost of Construction: $ S J'1�`� . -- Utilities: _ Sewer ❑Septic Building Height: iU OWNER/LESSEE;" 'r CONTf2ACTOR', (se.(J Name rlfne- VO4A ice `\'Wjan J,Le,� Name: Q f2s, -S (Welk �"s Address: 15 ROA NO). ice` hVe. Company: City: Nifl-M., State:EL AddresTeY s:M30 N. 6?94-"( City: 4D)1uW4Yk-1 Stater Zip Code: 331b�1 Fax: Phone No. 3b5 -to-&- L 1P 13 Zip Code: R3E)a6 Fax: Phone No. 955('720 •OcfOs E-Mail: Fill in fee simple Title Holder on next page (if different E-Mail: w1habe State or County License: Ee ObDqq75 from the Owner listed above) If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION'LIEN LAW INFORMATION`' DESIGN ENGINEER: Name: _ Not Applicable MORTGAGE COMPANY: Name: _ Not Applicable Addres : I?Address: City: Or Zip: 3 , Ma Phone:5//,/—,2V/, ate: �L. -.37/3 City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: Name: _ Not Applicable BONDING COMPANY: Name: _Not Applicable Address: Address: City: City: Zip: Phone: Zip: Phone: UWNER/ 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 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 applicationsare 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 nr an attorney before commencing work or recording vour Notice of Commencement. 1 Ignature of Owner/ L sse/Contractor as Agent for Owner Signature of Contrac License Holder STATE OF FLOR DA COUNTY OFrypl STATE OF 0 JDA p ci COUNTY OF I�rauJ6 xt`% m The forgoing instru a .was acknowledged before me The forgoing instrument was acknowledged before me this �day of I trGfi� 20jlby this al day of TMrCLln 20Ig by (o S q :Ses1.vn kc 4 P� a. G a=� t Name of person making statement Nameof pp, making statement Personally Known OR Produced Identificatio Personally Known . - OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Not f9'P lit�3 CEDENO Signature of Notary y,,3ff� Stite ofEEl7e, ==0987 .,Tar � Commission No. •��'� MY cIQN #FF784069 Commission N0. F •. (n�EXPIber 16, 2018 Flrysemce.mm REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE L4I5II 4Jt7t1& RECEIVED DATE COMPLETED Rev. 8/2/17