HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONP85S
ALL APPLICABLE INFO MUST BE COMPLETED FOR.APkII � TTION TO BE ACCEPTED Q n �R
Date: _(Q • Z� • I� BY Permit Number: I U OY N
; 2 St. Lucie County
M • ► RECEIVED
Building Permit Application JUL S1 018
Planning and Development Services
Building and Code Regulation Division Permitting Department
St. Lucie County
2300 Virginia Avenue, Fort Pierce FL 34992
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED, IMPROVEMENT'LOCATIONs
Address: 151 % G. US i i'IGtViyjcl i1
Legal Description:
PropertyTaxlD#: J��a-85� t�OUr i % Lot No.
Site Plan Name: / Block No.
Project Name: P14 W1 11• 11 69 \/&A U gfl YiU
Setbacks Front Back: Right Side; Left Side:
DETAILED DESCRIPTION OF WORK:
I6Y wfi-cYAt16-n fv W f O¢ , 404 meWOF6XMt< cry wfwal
Gam. WW C"W tfd w446 or w i . ( is llv+c'�raF
E�asnN c ,s P�+i� � 11If WW * pjAWTK�pS PI�N�
CONSTRUCTION INFORMATION:
A(1rlmnnnlwnrktnnPnArrnrrnPr1 iinriprthiq nPrFFFt—rhPrk nil T at ann v
HVAC L—II Gas Tank
Electric Ix Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $
I
Piping UShutters ❑Windows/Doors
nklers 1:1 Generator 11 Roof = Roof pitch
S Ft. of First Floor: _
Utilities: Sewer ElSeptic
Building Height:
OWNER/LESSEE: ,
CONTRACTOR:
Name
Name:
Y
Address:
Company:
f-i VIJc� Y q1 (.1 I(/V t
City: Stater
Zip Code: Fax: 33 y � • �
Phone No. 84; . f!f�
Address: 4
0M KAXV�-MVM� 1
_
City: State: rLI.'',,
Zip Code: Fatx:' 901 (:1���q +! Z
Phone No. 61 yL41
E-Mail:
FilWn fee_simplrTitle-Holds on next page ( if different
from the Owner listed above)
E-Mail: k Q��b161
A
Y�AIYIIC i/ 41� •G61�
State or Count e: c r c,JQ WK
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable I BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
Address:
City:
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 additf1s,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non- sidential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in yo, paying twice for
improvements to your property. A Notice of Commencement must be recorded and p "sted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or attorney before
commencing work or recording our Notice of Commencement.
:ZA 4=1
Signature of Ownerl Lessee/Contractor as Agent for Owner
-
Signature of ontractor/Lic
se Holder
STATE OF FLORIDA
STATE OF FLORI A
COUNTY OF }��\�
COUNTY OF !l,QiiYiL
I�L6LQ/
The fo going instr ment was acknowledged before me
�
The forgotng instru ent was
acknowledged efore me
this day of _NLA.�_ 26A by
thisday of N I IAIYI XQ
. 20A by
M\KrciP\
rJtrcon
� uflw
Name of person m ing statement
Name of pe so making statement
Personally Known X�R Produced Identification
Personally Known OR
Produced Identification
Type of Identification
Type of Identification
Produced
Produced
�\\1111111111
EInM
CJ
"\`\�����
(' nat a of Notary Public- to of Flo ida)
(Si nature of Nota Pub - Stat _ lorida) act :m
A S
to ,,..,,• DWASHECKLER
Commission No. _ '`Se mmiselon#GG2306
o
-�'m • ��'
Commission No. z3 j.m x
e� EXPlres June 16, 2022
�or
°i,thru
FLU BoMed Thiu BuApHN Wy8mtg
iG��i
�Ys i es .•
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
Tq�'
SEA TURYQ......i�OVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
EVIEW
DATE
RECEIVED
DATE'
COMPLETED
Rev.8/2/17