HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPIETED FOR APPLICATION TO BE ACCEPTED
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Date: %• LR - SCANNED Permit Numb
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_., BY
LA
e St. Lucie County
MAY 0 1 2018
Building Permit Application
Planning and Development Services
Permitting Department
Building and code Regulation Division
St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
,'0. §ED-IMPROVE
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Address: 7<lav .5 DCeiqnl b9iye t46/6, 3SFPV,5F/U '23en6V F4 31g5 %_._A
emborlrUm c' u/ur 616 4AJ6 wf6 Pef)-Z�t7(1
Legal Description: SRIub &LLr+K Vtw4« lu
S)_1,gRIIU e6/oM6,0
PropertyTaxlD#: 3S�2�D� DD3S-ODD`Q Lot No.
Site Plan Name: Block No.
,
Project Name:
Setbacks Front Back: Right Side: Left Side:.
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DESCRIPTION
,DETAILED
T N,Sc}LLa-r16,0 d F' /¢CCfJRZWU SkU:77F2 61U 23AL&N 1
IN__FORMATION
CONSTRUCTION
AclaitionalworKTODEIrformed un ert ispermd—c ec a appy:
❑
❑HVAC Gas Tank ❑Gas Piping Shutters Windows/Doors
n—Generator
Electric Plumbing Sprinklers Roof
Total Sq. Ft,of Construction: S Ft. of First Floor:
Cost of Construction: $ �` 7DD - 66 Utilities: Sewer Septic Building Height:
v { s
CONTRACTOR
_OWNER/LESSEE _
Name / BEN
Name
(6RfiF4(_ ANP?((
Address: %-//Z 30651W b6fuF 'W-c 11lG
Company: MVA AM4E 2qO %
� X City: SW Ue416'f Stater—
Address: M)6 SE ! /--/1),E
City: b&F ottA State: %
Zip Code: ,3057 Fax:
Phone No.
_
Zip Code: c� f6JFax: 772'�y5--3,)y7
77,�JW5-33Dd
E-Mail:
Phone No.
Fill in fee simple Title Holder on next page (if different
E-Mail:
from the Owner listed above)
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: Not Applivable_� MORTGAGE COMPANY: _Not Applicable
Name: 6eILINoff K, 6n7n;t5-ro C(_ra<:ss Name:
Address: 1 do sw r 7_�LF Address:
City: 15-I F I en-° '6ct± State: FL City: State:
Zip: 3'iuK - Phone:(-5 S • 06 60 Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable I BONDING COMPANY: _Not Applicable
Name: _
Address:
C'It
Name: _
Address:
y.
Zip: Phone: I Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in con Act 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 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
_ Signature of Owner/ Le& /Agent
STATE OF FLORIDA
COUNTY OF a xcae_
The forgoing instrument was acknowledged before me
this lLOT"dayof MarclrN_ 201%by
STATE OF FI
COUNTY OF
The forgoing instrument was acknowledged before me
this _g�2 day of "P-i C 20 by
(Name of person a nowledging) (Name of person knowledging )
nature of Not Public- State of Florida (Signature of Notary Public- State of Florida) G
Personally Known OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Produced .CC, 'Drier_ U ug Type of Identification Produced
y,� SHELUE-ANN MORGAN Commission No. Seal
Commission No. - N�I PUBLIC
STATE OF FLORIDA STEVEN TREPEC.
J/,,.. 1a FF9771
/oe to Expires 9/29/2018 14ay WINGS: M=h30, 2020
Revised 07/15/2014
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVI
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS