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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMF�c i'�D FOR APPLICATION TO BE ACCEPTED Date: 7f I3�a071� Permit Number: SCANNED ' '.�a' . °=so BY t St. Lucie County Building Permit Applica Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial PERMIT APPLICATION FOR: dZeAl I-v 19 7 / ©�� PRQP.OSED INPRO�U,EMENT LOCATION: / YO % 5�7. R Ulm; EIS on JUL 1 12018 Permitting Department St. Lucie County, FL Address: g886 S. 069.ri DW/J.t4 /J?/r 11?0,e Legal Description:( 1A/aog ?SCAxU DUfiES nrE,4A✓SJdG 0200 X oz act wy d r6 oa3311 Property Tax IDif: ?S3S-6ap - 'op O�y Lot No. Site Plan Name: Block No. Project Name: /,41AA'o and—S _-4 - Setbacks Front Back: Right Side: Left Side: _Mechanical _ Gas Tank _ Gas Piping. _ Shutters -Windows/Doors V, Electric Plumbing _ Sprinklers _ Generator Roof Pitch Total Sq. Ft of Construction: /000 Sq. Ft. of First Floor: /0 000 Cost of Construction: $ Sj'Gwa Utilities: _ Sewer _ Septic Building Height: _ OWN ER/LESSEE: CONTRACTOR: NamZRClEP T/RGG/D, ¢ SUSAU .SrJMZ K Name. mf-. Address:3/(� lr.E'ST�Z? ie0>20 Cd}ri0,6v Ak2JOA C04us7Frjlou I� FSs/oti4�s City: Lvf[.1'4•v Zip Code: // Fax: - Phone NO. A03- P5,6 -SS70 � State: C Addres/�s l��a SE FyJ/�iEJo fI�/ErLyF City: I12T S9144- LUl/,5 Stater Zip Code: Fax: Phone No 77 E-Mail: Fill in fee simple Title Holder o next page ( if different-. from the Owner listed above) j, jj Leoa nci vi 40 E-Mail 713/<6frS ® GONfe4s;r State or County License CGCOS�/T toc 10bci(.n2f If value of construction is 2500 or more, a RECORDED' Notice of Commencement is required. X SUPPLEMENTAL CONSTRUCTION DESIGNER/ENGINEER: Name: LIEN LAW INF Not Applicable R ATION: MORTGAGE COMPANY: Name: Not Applicable Address: - Address: City: Zip: Phone State: City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: _ Name:AmA iO / Not Applicable BONDING COMPANY: Name: Not Applicable Address:,?/(o Address: City: 4,9_ AGO n�EC /C� City: Zip: OG Phone: a703 X5G- SZRO Zip: Phone: 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 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 cornmencing work or rpcording your Notice of Commencement. Signature of Contrac or icense Holder Signature of Owner/ Lessee/Contractor as Agent for Owner STATE OF-ELBRtBit STATE OF FLORIDA COUNTY OF f n ( Gt' PA COUNTY OF me k o The forgoing instrument was acknowledge c�,before me The forgoing instrument was acknowledged before me this � day of � WWI 20 V by this `� day of _� 20 IS by 4-y�niicY Vi Rndrew1 Ql-eqeg- (Name of erson acknowledging) (Name of person acknowledging ) �C�Lyt. Q in o,I.uu- (Signa re of Notary'Public- State-offforida) K (Signature of Notary Public- State of Florida ) Personally known OR Produced Identification _/ Personally Known ✓} OR Produced I n 'fi ti Type of Identification Type of Identification TAMARA A. GROUSE Produced „ Produced 2 Q • I °'� y public - State of Florida J NIFER VIEIRA =�: .= Commission # FF 995668 Commission No. 155 aARYPUTISej[h OFCOBNECTICIIr (1 Commission No. q 9 •o My C4 Ejlpires Jun 12. 2020 My Commission Expues Oct0Cer31 i0ii Bonded through National Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLA VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW RE REVIEW REVIEW REVIEW DATE RECEIVED DATE SI COMPLETED b I nev. 7/2014