HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATI0I970 BE ACCEPTED
Date: k SCABN�NED Permit Number:
St. Lucie County • RECEIVED
�1
Building Permit Application - MAY 012018
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 Q.e k'.,, . 1
Address:
Legal Description: -LSL#if'l)_—r:) GAa67- CorAot [A)/UM
Property Tax ID #: �A 5/1- ,j 14 ^ e-)6 0 - QQU -A? Lot No.
Site Plan Name:
Project Name: ISLn A)h CPJC'�-7
Setbacks Front Back: Right Side: Left Side:
(ONC2eTO,
Pd2 iJAJl7
SlD, We) ,l /0/0 / ///C'9 4�4 t Z-/o
Block No.
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CO[ �STROCTIONk!NFORNIATIQN.:
forme
itiona work to
e e under
this permit- c ec a
apply:
1IHVAC
0GasTank
[]Gas
Piping
_Shutters
❑Windows/Doors
1-1
Electric
0
Plumbing
Sprinklers
11
Generator
1:1Roof
=
Roof pitch
Total Sq. Ft of Construction: zow
Cost of Construction: $ �Llrr% 000
S Ft. of First Floor: _
Utilities:Sewer Septic
Building Height:
0 ER ESSEE a..•; a<
ONTRAGTOR
Name lS A" GA"_CoAIDD
Name: 1 T001J f
Address: /06f30 S OGFA-n1
b/Z
Company: I? I� Coo�h
/'�
l-d?bi-UG
i 63f
city:
Zip Code: Fax:
Phone No.
State: (
Address: ZRRR- SF- /'YOAIfZox_�7 A7
City: S-M 4lLT—
Zip Code:34!0 Fax:??2.
Phone No. 5� l/- G 3 2-
State:(_
W_534s
3S U
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
/
E-Mail: a G/ &'Q 6 L.Q.
C G % . cb'n l
State or County License: (' ('
l Fz 00 4 2
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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! conflict with any applicable Home Owners Association bylaws
rules, or andcovenantsthat 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
commencingwork or recordingour Notice of Commencement.
STATE 0"16A
Rev.8/2/17
SUPPL=tMENT4l.CON5'tRU0T1ON i�EN
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: _Not
Name:
Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
Signa re o r essee/Contractor as Agent for Owner
Signature of ct rat older
STATE OF FLORIDA
COUNTY OF
COUNTY OF S}_ LUc:rC
The forgoing Instrument was acknowledged before me
V
The forgoing instrument was acknowledgedbefore me
this day of 20-1T by
this Ndayof,20�V by
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced Q t-
Produced C � b L
(Signature of Nota cl6,li.=.State dta'fd'fRd��F�IE"�' 't
�'•
(Signature of Nota ublic-State of Flo��--""""�=�'�5
J. d
-"' AMARIE GNENS
Commission No. .u.s•;� \ 7tGG 022023'
?' MY COMMIS610NA�>(I t�rl y
Commission No.
MY COM�e�ay
Dece Myer 16, 2020
ded ilw NotS���lj:'dnuerar�r--,_ �j
?r.a= FJ(PIRES:
N NotaNP❑ylic
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
2 p
RECEIVED
DATE
COMPLETED