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Home My WebLink AboutBUILDING PERMIT APPLICATIONIa All APPLICABLE INFO Mus'r BE CO:-:. _ETED FOR APPLICATION TO BE ACCEPTU, Date: �� a �� SCANNED Permit Number: BY St. Lucie County RECEIVED s Building Permit Applical ion NOV 2 7 tote Planning and Development Services ST. Lucie Count., Permitting Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34992 Phone:.(772)462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: PROSED)RO\/EMENTuL©GAI13N F t # x. Address: `Y Legal Description: — n W - q - Property Tax ID#: tC/A5•--hQ-0 IQ^ 00 Lot No. Site Plan Name: 1+^}� Block No. Project Name: m Y Setbacks Front Back: Right Side:- Left Side: L .!ca R'•^i^p ..a'.,= Jai�?�tus...'fi.$d �, A�FM>a*'4...M-x.y.;�-d ;�i 9� �.:<'x�u': yt0..c.,�a �-'+ ;+` t.:v.�' ��.2� �..�.a.ad�k:d'� �..�E' �'h r GOISTF�UiI@NNFOR f, �f-ui .x„ W& .� mono wor to a pe orme under this permit— check all that apply: Mechanical \,Gas Tank _Gas Piping _Shutters Windows/Doors �! Electric ".Plumbi _Generator _Roof Pitch /_Sprinklers Total Sq. Ft of Constructi W5'Y 1 X 6 Sq. Ft. of First Floor: Cost of Construction: $ 0d Q� . 8 , Utilities: _Sewer _Septic Building Height: 171ACOR��;.� Namc_ yWATn-EJtAMgj l Name D Address: Company: City: —rStater Address: —� City: Stater Zip Cade: Fax: Phone No. d Fax: Phone Now;- E-Mail:�� / L ,n() fY,' Fill in fee simple Title golder on next page (if different l IStatorCounty License 4 from the Owner listed above) If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. fO le-k 772 n S "w117;cri,4G,i•�77�DIY' 2�} "' } G.IfiYYg IYC„Ril F5{'Jt,�.,yy`«§S,' £yi,':r.�ru.`a DESIGNER/ENGINEER: Name: _ Not Applicable MORTGAGE COMPANY: Name: Address: _ Not Applicable Address: City: Zip: Phone State: City: Zip: Phone: State: FEE SIMPLE TITLEHOLDER: Name: _ Not Applicable BONDING COMPANY: I Name: _Not Applicable Address: I 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 anycovenants 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 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 rerordine vour Notice of Commencement. essee/Contractor as Agent for Owner SignAtrOF071R41DA- Signa ure Holder STATFL .. ZctUcense STAT F FLO COUNTY OF k+C c COUNTY OF The forgoing instrument was acknowledged before me . The forgoing instrument was acknowledged before me thisda\y(off >.boP 20_aby this2. day of t)�z- 201$ by (Name of person ac nowle ing) (Name of person acknowledging) ) �1t1ism �L (Sighatuee of Notary Public- State of Florida) (Signature of Notary Public- State of FlbNda ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification ' Produced Produced " dGRkM` p Commission No. _ _ _.,.,- _. (SeLI) (,,;GRAM Noiary Public - State of Florida Commission No. : • My Con(l5ea4tres Dec 20, 2018 f( =��'°'Y'�`a��: P�bl�o -State of Florld '',;�of 1toa c'Q Camml'slOn ;� FF 177249 @oYry go p Bolbtd thro A ' REVIEWS FRON omi r ' Gcom t 1M1�t n. LANS VEGETATION SEATURTLE MANGROVE COUNT "' °ll neeat ro VIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 7/2014