HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COrvirUrED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number: �(V U�7UY
BY
St. Lucie County RECEIVED
Building Permit Applicati 3n OCT 31 20)8
Planning and Development Services ST. Lucie Ceunty, Permitting
Building -and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: 5.7ef— & ?_N6Vk41alio
Address: OO 5 • C.fAW S2.N e-&a VaN L -;S- { 5
Legal Description: :�!5 1 Q }7ci r([ ( a ;ail 1-n /111� 1 f /9,6 7&
641ad�
Property Tax ID #: U,% -Q[%,- 6M -d Lot No.
Site Plan Name: Block No.
d
Project Name: !J N S 1D�101Y1�t
Setbacks Front Back: Right Side: Left Side:
kywhVMe- YV1th s4er Cor \ief A- 4-9000 %04+6 Sbo\ 0- • lilt
DlulmbiNJ cdumck
r•eDe.J+. fe"Ve W411 bm"M
vshiv 4-4 ii
1:iml-e.•�-.
Adlck pac.ke,+ do-60-4 ► VU 5 616. '
witionar to be pertorMed under this permit- check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
XElectric Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: d Sq. Ft. of First Floor:
Cost of Construction: $ �1yr DDO • Utilities: —Sewer _Septic Building Height:
Name • 5 D Name:
Address:_g�JOO S. aawDg. i/f-/9,d% Company: /7S
City:.�NPNSeAl AC4 State: Address:
Zip Code: 3Y9 57 Fax: City: 3/Y-7X?9�k,�7 State:
Phone No. `7`7 ?,%- `lam - 3�27 Zip Code: .3;�1QR Fax:
E-Mail: IN, AA(xAW\�l` 5.NeT.NSr phone No 'fin/-P:&:5S,75
Fill in fee simple Title Holder on next page ( if different E-Mail o
from the Owner listed above) State or County License /o
If value of construction is 2500 or more, a RECORDED Notice of Commencement Is required.
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY:
Not 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 Copnty 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 accessary 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 Noticp of Commencement must be recorded and posted on the jobsite
before the first ins ection. If you intend to obtain financing; consult with lender or an attorney before
commencing worV6r recording vour Notice of Commencement.
f c
Signature o 0 Lessee/Contractor as Agent for Owner.
Signature of Confact r/License Holder
STATE OF FLO IDA r—
STATE OF FLO'4p, ..
COUNTYOF 5T• U'. 1 t_-,
COUNTY OF
The forgoing instrument was acknowledged before me
tcr
Thefgrgoing instrument was acknowledges} before me
this _ day of ✓ . 20L%'by
this day of D2v . 20Ljby
•
(Name of person acknowledging
(Name of person acknowledging)
(Si ature of otary Public State of Florida)
(Sig ature of otary Public- State of Florida) '
Personally Known OR Produced Identification V,
Personally Known `' O P c
Type of Identification
• • BRENDA LEE FLORES
Produced . • o`l Y° e;c•
- . > -Notary.Public - State of Florida
' o�lmissiRn # FF 206852
We of Identification ..„ BRENDA LEE FLORES
•'�" °be''�
Produced ; o "A Notary Public - State of Florida
..
= , -F 0�t mission # FF 206852
Commission NO.' fires Jun 15,
e ligtd8{nm s Jun 15, 2019
Commission No. {
om 2019
'
BopdedlbroughNationalNotary Assb.
Bonded through National Notary Assn.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLA
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW .
RE
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
7
COMPLETED
Rev. //ZU14