HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE Co�x117(Eb FOR APPLICATION TO BE ACCEPTC,
SCANNED 0 031� 2
Date: rjL/
BY Permit Number:
St. Lucie County
RECEIVED
Milling Permit Applicatic n
NOV 2 0 2018
Planning and Development Services
Building -and Code Regulation Division
�T. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residenba�1�7
PERMIT APPLICATION FOR�:
Address: On 50C�2� Rc,� FL, -:54q5'rl Oef 763
Legal Description:-Milond'TA U e 6:21)
PropertyTaxlD#:
Lot No.
Site Plan Name:
Block No.
Project Name:
,Setbacks Front. Back:
Right Side: Left Side:
A-10(4--k
allA-e40
A
"itional work to be pertornned under this permit -check all that apply:
Mechanical GasTank
Gas Piping — Shutters —Windows/Doors
&Electric Plumbing
Sprinklers — Generator Roof Pitch
total Sq. Ftof Construction: /26�
Sq. Ft. of First Floor:
Cost of Construction: $ IS:1 aar,- c-A
Utilities: —Sewer _Septic Building Height:
4 05e, 01
Name�-�V'�P-
Name:
Address: 0,5oo 50cqf1,.116bJ6 11W
703 Companyigf��#-�tJ �eCAAOlcp'eS.Lk
City: JeA/S e"J 1JefCA
State:Fi'- Address: o7 i M6 9 0,
ZlpCode: 3Yq5'2 Fax:
City: $ocn N State:
Phone No. 'fl 7 - 117 �5i - 2,2 -Z -5
Zip Code: 3 ;'(,J Fax:
E-Mail: Uh4wy�o ga�o/" com
Phone N 95 Li 2 - QG9 S'
Fill in fee simple Title Holder on next page (if
different E-Mail 9jeNmjA446Nqe<t1 IWC-Cc' Y4 ov
from the Owner listed above)
State or County License <CZ5 -C 7
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
LJC31%7 IV CK1 MMU I IV LM
NOT APPI[CaDi.e
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
NotApplicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Pho�e_-.
Zip: PhDne:
OWNER/ CONTRACTORAFFIDVIT: 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.
no
structure.
ermit holder to build the subject structure
covenants that may restrict or prohibit such
it 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 tilvice 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 recordine vour Notice of Commencement.
A�� I
&ZX-5 V,7z -
—
Sign6ture of OwneV7 Lessee/Contractor as Agent for Owner
Signature of Contra�tor/Ucense Holderff
STATE OF FLORIDA
LO
STATE OF F Rlq�
COUNTYCIF
COUNTYOF
The forgaing*instrumefit was acknowledged before me
thisAQdayof 1-,�01,(e0N0Z,_26Zby
The forgoing instrymiant was ac)knowledged before me
this,2,�)dayof 1\,�XJeA 2nliolby
(Name of person ac dgj
(Siknature of Public- State of Florida
(��Notary Public- State of Florida
,plo—t—ary
Person-ati-v Known uced 16
lelffidalblic0*0
.Type of Identific O� NotaryPublic-'State of Florida
&.310 Commission
Pers It Produ%*WArL#%&A L�
onall Kno
Type of I e tifi Notary Public - State of Florida
Produced # FF 206852
produce Commission # FF 206852
my Comm. Expires Jun 15, 2019
J�6de hm h National Notary Assn
0 i�m. Expires Jun 15. 2019
Commission! No. N_ ea
out
Com issslo 0 _qfflal Notary Assn.
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