HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST.BECOMPLETED FOR APPLICATION TO BEACCEPTED
Date: 7 �S 1 1T a Permit
SCANNED
L BY
• St. Lucie County JUL 05 2018
Building. Permit App kat OL
Planning and Development Services - CounYy;Permitdng
Building and Code Regulation Division
230O Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox,.ciick arrow at the end.of line
PROPOSED IMPROVEMENT LOCATION:
Address: I SdUef
Legal Description:
Property Tax IDq: 2,� i T Lot No. L
.-Site Plan Name: Block No.
I
Project Name: G I Uli {to ✓6e
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:.
"
�R— foui
C 1 b Q%3 s-e,
CONSTRUCTION INFORMATIONS
AGaitionalworl(tqbWertormed un ert is permit check all Mg apply:
❑HVAC GasTank as Piping r Shutters ❑Windows/Doors
' ❑Electric".❑.Plumbing Rprinklers ❑Generator -2-Roof ' ❑ Roof. pitch
'.
Total - Sq.'Ft of Construction: S Ft. of First Floor: I `� o $ Uales
'.
Cost of Construction: $ 1+9 i 0 (7 6 Utilities-tsewer❑Septic ` ' Building Height: 'I
OWNER/LESSEE:
CONTRACTOR:
Name W uP�
CG
Name:
Address: IUDU ` / rN
Companyc ILLS w: -iyx _
City: ., I State:
Zip Code: ?F�9 Fax:
Phone No. 772- 2'-
Address:-757�. $= J
ear -
City: o art i e�2eC State
Zip Code -<Z44/ Fax: q
Phone No.. QS
E-Mail:- .
Fill in fee simple Title Holder on next page (if different
from,the Owner listed above)
E=Mail• '
State or County license: CCGa S -7 9 Z 1
If value of construction -Is $2S00 or more, a RECORDED: Notice of Commencement is required.- - -'
L•
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _No pplicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: _NotApplicable
Name: 7f
Name:
Address:
Address:
_
City:
City:
Zip: Pho . -
Zip: Pho .
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation asindicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Counttyv makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in conWict with any applicable Home Owners Association rules, bylaws or angcovenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for anyrestrictions 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 FloridaBuilding 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,ns t with lender or an attorney before
commencingw re or n our Notice of Co mence ent. f!
t
i t
t o Owner/ essee/Contractor as Agentio/oWner
Signatur of ontractor/License Holder
STATE OF FLORIDA
COUNTY OF St. Lucie
STAT F FLORIDA
CO OF
The forgoing instrument was acknowledgedbeforeme
The for oing Instrument was acknowledged eYore me
this2Z day of .Tune. . 20 by
this day of S✓L 20/ b
Joel F. Wynne
—DIAy I'h CpP&4f✓
Name of person making statement
Personally Known X OR Produced Identification _
Name of qtrson making statement
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
_Produced
Signature of Nota " - t rida
Commission No. 1;= "Y�y&i:b SU^ EE
_ YCCPdN�FF187647
EXPIRES: Febma, 23,2079
�,q;,I;4•" aonded TfiWiZtW/Pcbre Undenmten
(Signature of Nota
" TOOD C ANDERSE N
Commission No. ` "I My COM49%16 P'FFis7639
East EXPIRES December 27, 2018
(3®3 399�1"
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS VEGETATION SEA TURTLE - MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
M
DATE
COMPLETED
Rev.8/2/17