HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONSCANNED
By
St. Lucie County
ALLAPPLICABLE INFO MUST BE COMPLETED FOR APPUCATION TO BEACCEPTED
Date: "" Permit Number:
Building Permit Application RECEIVED
Planning and Development services _
Building and Code Regulation Dikkion - NOV 13'2010
2300 Virginia Avenue, Fort Pierce FL 34ga2 ' /
- Phone: v (772) 462-1553 Fax: (772) 462-1578 Commercial Residentig?rmltting Department
SR-NKNe-County
PERMIT APPLICATION FOR- To Select from dropbox, click arrow at the end of line
Address: 1 Uy 2
-Legal Description:
IRLh R14, OF ErOVr "r s i.'V(a F OF IliA W-010-Pr l LOV- 4o7v- 12krlta
PropertyTaxiDS: Ofle>2 - o20 - 1 Lot No.
Site Plan Name: Block No.
Project Name.'
Setbacks Front Back: Right Side: Left Side:.
nuumuum wu,n w u .wuucr, curt. r.c, rc,..... .. -.. rr•.-.
❑HVAC Gas Tank Di as Piping j�_Shutters ❑Windows/Doors
11 Electric Plumbing OSprinklers OGenerator ❑Roof Rodpkch
Total Sq. Ft of Construction:- SgrFFtt,� of First Floor
Cost of Conswction: $ 1 (D � 153- N it _ Utilities L �JSewer E ]Septic Building Height:
Name:
cit�Stater Address; 59-5n W Nk t�l taut tS4r WSI`1
Zip Code: Fax: City:_ 'j�k, vt C State.:&
Phone No. e4ipi- 1�14- AS3 Zip. Code: 47U24 Fax: qr4-(go w 5120
E-Mall: 66yi-55A. Phone No. qT4- 5137 - fon4B
Fill In fee simple Title Holder on next page (H different E-Mail:
from the Owner listed above) State or County Utense: YJ
Hvalue of construction is Stsoo or mare, a REeoRDED Notice of commencement Is required.
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Name:Obyfa;CL.
—'" `^Ypii�duir
I MORTGAGE COMPANY: _Not Applicable
(t.n;i
A:GS
Name: Niq
Address:R,I
SIr to
Address:
City: Cltdvwtt1tF
Stater
City: State:
Zip: 21-7„u Phone
; 3i - q-h"Z
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _
NotApplicable
BONDING COMPANY: Applicable
Name:_ _ - ►j' W
_Not
Name: N �b
Address:
Address:
City: City
Zip: Phone: Zip:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
certify.that no;workor 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 [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 undergoinga 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#d.youi 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
commenring work orrecording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner
Signature of ntractor/Ucense Holder
STATE OF FLORID "' r_
�Gt I ('324C h
STATE OF FLORIDA
COUNTY OF
COUNTY OF rY�
The for oing instrufnent was ac�c nowledged before me
The forgoing instrument was acknowledged before me
ci -dayof KiVCirtity by
this tlay of �NCiJ2f2' Vs¢,��20Lbby
this .201O
Matrk C.l`1cL:lSlr1
Sco+! li,sk;h,y.4.'.
Name of person making statement
Name of person making statement
Personally Known OR Produced identification
Personally Known_ OR Produced Identification _
Type of identification -
Type of Identiffic
_
P duced
Produced _y/�
KRISTIN� ROBAN
•
Signs[ re of Notary IeoC 11IGG 2271a6
(Signature of Nota ' -S 'RYGdCIak .,,
ay Comm. Expires Oct 7, 2022,
-NOTARY PUB IC
Commission No. TE Od RIDA Commission No. Bonded through l(See1)NotMAssn.
.
Colnm#GG01549502
SE ETU E M
SMANGROVE
R VEGETATION
PLANS
REVIEWS FRONT ZC1RVIS
COUNTER REVIEW REVIEW REVIEW REVIEWREVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
_�ac,a, sir