HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONib FOR APPLICATION TO BE ACCEPTED
All APPLICABLE INFO MUST BE COMPLETE
Date: Permit Number: �A (�)A - 6%
SCANNED
BY RECEIVED
St. Lucie County
Building Permit Application AUG312018
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial —/— Residenti al
PERMIT APPLICATION FOR: Vahlid5r?� SVOL05 1/41
1,P4 130 POS E PJ I N� P
wRO EM.Y fflNMJffi0AJTiI@N�-llll
Address:
Legal Description:
'fvi 3
Property Tax ID #: Lot No.
Block No.
Site Plan Name: 5 4 C0451 C-VP-0 R 410ATL
Project Name: 52 C045r CO255
Setbacks Front Back: _ Right Side: Left Side:
cowyc�T;- s444� lrocI46f Tlod. 410-w?f 115y4n� r5e w4u-5 azn—�—) W/A/ c4rE5"
7
0\4-�s- tt V C(w'�X od"A!5) ,
� crieCK a
Mechanical GasTank Gas Piping
— Electric — Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
Q600
Shutters Windows/Doors
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
raNNNE flESSE - U1=1
[G 0 N ITI MCZTL@ M
Name - ezS46a4,Gr 012P,6-5
Name: 0Cu&&f 5 )Of W5
Address:—SCOV0 14f1dvs7r,1*- � 4tli- 3
Company:4/6V*/W A- 104VI�; 691131"C"W
City: P-7,0r7V- --State: AL
3 q9 ax:
Zip Code: F
Phone No.
Address: /0 /01;?
City: )c:r lo,4�cc6 State:
ZipCocle: 3-1195tl Fax:
PhoneNo 777- �4(ol 2M5
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the owner listed above)
E-Mail clela Is &rke1ov:1s.c-e-Y7
—
State or County License C&C 0/30,94
If value of construction is 2500 or more, a RECORDED Notice at
is requirea.
WIN
rSTUP.91HE �"NTFALKCOONS)TIRUI.C-ITIIQNiLlIENIL!A%,A'WJINF-,R
DESIGN ER/ENG1 NEER: Not Applicable
MORTGAGE COMPANY: Ncrt Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: —Not Applicable
Name:
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 ma estrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions Yhr ch may apply.
w
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
commencing work or recording your Notice of Commencement.
4n�� Irvo &Xwv
Signature etewffert-�/Contractor as Agent for Owner
Signature of/Contractor/License Holder
STATE OF FLORIDA
COUNTY OF e,4_
STATE OF FLORIDA I
COUNTYOF -Sh. "0-0,
The forgoing instrument was acknowledge, before me
this1:0% dayof by'
The forgoing instrument was acknowledge before me
this]�.�dayof by
A
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Produced TV j>
Type of Identification
Produced '�-L,,D
(Signature of Notary Public- State of Florida
(Signature of Notary Pdblic- State of Florida
Commi ssion No. NJ;A15K1C0 I (Seal)
Commission No. M %114 1 (Seal)
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