Loading...
HomeMy WebLinkAboutBuilding Permit Application (2) I DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: Stater 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 may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for•any restrictions which may apply. i 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 our Notice of Commencement. Signature of Owner/Agent/Lessee Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORID� COUNTY OF ��"� ( �, COUNTY OF____cLl,{ t �- The forgoing instrument was acknowledged before me The f rg ing instrument was acknowledged before me this�day o 20 by thispday of ' 20IJ by tl _..: (N n6Ql6d9ifigE)4CH (Name of p rson acknowledging) Notary Public=Mate of Florida ?•a a°_ Comm.Expires Dec 1,2017 mm 'on # FF 069924 (Si'gna /tic ,Sta#znftaticJ ) (Sign ure of Notary Public-State of Florida ) Personally Known ✓ OR Produced Identification Personally Known O P o c d I cant,ifica 'o Type of Identification Produced Type of Identification P cury n FRPMr.HF •'•°t„a� �`� Notary Public-Mate of Florida _ Commission No. lQ 2� (Seal) Commission No. ;N _ My Co(SeBkhires Dec 1,2017 a,,:' Commission #FF 069924 °� ��� Bonded Through National Notary Assn.` REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. i All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED II Date: Permit Number: 1�i01 Mo Building Permit Application Planning and Development Services 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: =111!111i 11411 Address:7 70/ loon n x Legal Description: /A-eWe0d A,K -11;,,'7- 7 - Abt Sr k' 1-6; I Property Tax ID#: , 30/ 6Q7.•- 6,-3-// — 00Q- 2, ! Lot No. Site Plan Name: Block No. I Project Name: Setbacks Front Back: Right Side: Left Side: a v,_siLk1/ 33'7 ©!- / ;j 6, wood r i c e a l0H� 7-7 c '/_3a.� a•+�( r3oT-di SicQ c 5 Ghat' av"d55 13 01-4 !ra01 o Coy-Eels © � /Ib LOS e wvit11 I -y'iv:de- W-J K Gates. cz-4J / -5 P w;di e 6/,--1 K Gatc, 00 Additional work to be pe rformed under this permit-checK all that appy: C. _Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors . Electric _Plumbing _Sprinklers _Generator `' Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor: I i Cost of Construction:$ -5:500• Utilities: _Sewer _Septic Building Height: Name l3ru-<A Name: ScoM Address: -7701 Company: City: I�%crc c State: /:_1 Address: 1?7o Sw.,A- !'osa 'et Zip Code: 3 '/9.6 1 Fax: City: h-57-_4vC_,•c State: Phone No. - 7 7 0 G Zip Code: 3 Fax: 72A E-Mail: Phone No. 77,?_ 3Y0-/'0'YS Fill in fee simple Title Holder on next page(if different E-Mail:- from the Owner listed above) State or County Licenser o`�6030 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.!, a