HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �'I SCANNED Permit Number:
BY
St. Lucie County
Building Permit Application RECEIVED
Planning and Development Services JUN 132018
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ST. Lucie County, Permitting
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial A— Resident
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
-PROPOSEDi PROVEMENTLOCaTtON
Address: 5799 S US Hwy 1
Legal Description: See attached property record card
PropertyTax ID #: 3410-244-0004-000-6
Site Plan Name:
Project Name: Jackson - 10704135
Setbacks Front Back: _
install 8 accordion shutters
Right Side:
lattionaiworKtooe errormea unaerrmspermn—ci
0HVAC Gas Tank ❑Gas Piping
❑ Electric 0 Plumbing []Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 8392.00
Left Side:
IVI Shutters
❑ Generator
Sq. Ft. of First Floor: _
UtilitiesSewer ❑Septic
Lot No.
Block No.
❑ Windows/Doors
❑ Roof
Building Height:
OWNER%LESSEE: 5'_�' °`
:CONTRACTOR '•',
Name Berean Church of God International Port St Lucie Inc.
Name: Raquel Swanner
Address: 5799 S US Hwy 1
Company: The Home Depot
City: Fort Pierce
Zip Code: 34982 Fax:
Phone No.
State: FL
Address: 6500 NW 12TH Ave. Suite 110
City: Fort Lauderdale State: FL
Zip Code: 33309 Fax:
Phone No. (754) 224 - 2010
E-Mail: &re,4t4C41&,kWV7_0JQ ocG.evM
Fill in fee simple Title Holder A
from the Owner listed above)
next page (if different
E-Mail:
State or County License: CGC1514813
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPFZLdMN�ALCONSTi2llCTifl{�:11EN LV1I IiVi ORMATIOIaf `:° =P ; a y ?;
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DESIGNER/ENGINEER: —Not Applicable
Name:
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City: State:
Zip: Phone:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 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
Lessee
Holder
OF FLORIDA STATE OF FLORIDA
FY OF 64� 1 E,64 COUNTY OF ff- I wC'e_
The forgoing instrument was acknowledged before The forgoing instrument wa{acknowledged before me
me this , day of f}Bf._r l 20 IVy this L day of EW l , 20_1 S"by
449"s2-111An4-/ �&9t-ei l�-z�
(Name of person acknowledging ) (Name of person acknowledging )
���
(Signature of Notary Public- State of Florida )
Personally Known X OR Produced Identification
Type of Identification Produced
Commission No.
(Seal)
(Signature of Notary Public- State of Florida )
Personally Known X OR Produced Identification
Type of Identification Produced
Commission No.
(Seal)
MY COMMISSION#GG 117135 _ MY COMMISSION#GG 117135
Revised 07/15/2014 _ %° EXPIRES: August 7,2021 EXPIRES: August 7, 2021
`%`,;, Bonded Thor Notary Public Ondemriters 11 F°' Bonded Thru Notary Public UnMea?iYz;
REVIEWS
FRONT
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VEGETATION
SEATURTLE
MANGROVE
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REVIEW
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REVIEW
REVIEW
DATE
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INITIALS
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