HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
SCANNED Permit Number:
BY
St. Lucie County
Building Permit Application
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 X Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line' W indovv it III
I PROPOSED IMPROVEMENT LOCATION: III
Address: 2995 Sou-Fh 25th Sjyett, For+ Pierce, FL 34981
Legal Description: 20 35 WO N -WO FT OF S ZIa6.04 FToF tN zw FT OF F_
zao.OLl rT OF, S 112 of SI✓ I/y OF- SF_ 1/4 (.oLo cl oR 1616-g5
Property Tax ID #: 2420- q LIy — CN0Q10 - n00- 2 Lot No.
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Block No.
o� S'- D fo.A.J/on} Vv irdovwS and cl3ofs .
CONSTRUCTION INFORMATION:
Additional work to e performed under
0HVAC 11 Gas Tank
ispermit —checka
Gas Piping
apply:
Q Windows/Doors
_Shutters
UElectric 0 Plumbing
Sprinklers
Generator
0Roof Roof pitch
Total Sq. Ft of Construction: 151:1S. U_5
Sq.of First Floor:
1!'D3.6
Cost of Construction: $ !a goo co Utilities: L _I Sewer Septic
Building Height:
OW N ERAESSE E:
CONTRACTOR:
Name MQ(ASiOt PetirOICUM II)C
Name: �+
Company: Inn0vQ .1'nn Coni-fG
c+l i1Ca I f1L'
Address:_zmY rnnLA" 7_CJ� SieU -
City: Fart p1efEe. Stater
Zip Code: Fax:
Phone No.
Address: ilII5 6onL-I\1
RWd
City: Fir+ PtefrP
Zip Code: ?agge)1 Fax:
Phone No.
State:,EL
�—
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: Ott)
(rire),iO i(inoQb
onc4D cAc-fi
State or County License: C`-I W
I I L=i I Q
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
COr
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
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
improveme s to your property. A Notice of Commencement must be Orded and posted on the jobsite
before the rst inspection. If you intend to obtain financing, consull lender or an attorney before
commen z work or recording vour Notice of Commencement.
t
Sig atu Ow er a Con or s Agent for Owner
Signifulre of Contra or/License Holder
ST F FLORIDA n,
al.0
�
STATE OF FLORID
COUNTY OF
JL (l\ lilt I X
COUNTY OF r/�
The forgoing instrum nt was acknowledged�efore me
The f5ygoing instrument was acknowledge fore me
this day of
20 1 by
this day of - 1_. . 201 y
Name of per or making statement
i
Name of perso making statement
Personally Known OR
Produced Identification
nown
Personally KOR Produced Identification
Type of Identification
Type of Identification
Produced
owmd PMJ_Q_
AtWN�6
Produced
lhkw� �W_ Aio 04\'A
Signature of Notary Public-
A ANDA R E B4
ture of Notary Public- 5 at
I,"
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Commission N
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I of FloriCp•NotPr
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Public ;
ssion.No
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°� Septer: oer 26.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVI
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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Rev. 8/2/17