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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: a-?v Permit Number: Q� RECEIVED •: Building Permit Application FEB 0 3 2017 Planning and Development Services PERMITTING Building and Code Regulation Division St. Lucie County, FL 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: PROP �QED 1N�ROUE SENT' LOCATIO,N:. _ Address: oZ�07 1 ti"DL t� L Legal Description: Property Tax ID#: (313 )_y ` 5;_0 t _ 0 C9 —0 0 0 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: G(k- eON�TRUCTIo IN o nn � o Vzlitional work to a per orme , un er this permit—check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors V"E'lectric —Plumbing —Sprinklers —Generator —Roof Pitch Total Sq. Ft of Construction: ,,nn Sq. Ft. of First Floor: Cost of Construction: $ 0V 1 ©0 Utilities: —Sewer —Septic Building Height: R �OW ..SSPE,. CDIUTR CT�QR: Name C S ame: Address: to rD k ,Company: City: i State: L Address: Zip Code: //Fax: City: State: Phone No. ._ 1 to-- Zip Code: Fax: E-Mail: Lo G( e (0VY1 Phone No Fill in fee simple Title Holder on neki page(if different E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. I SlJ 'PLEMENTAL CONSTRU TI,®N LIEN LAUV I'N' 'RMATI®N: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE BOLDER: _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 thepermit 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 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 imp r v ments to your property. A Notice of Commencement must be recorded and posted on the jobsite be ret a first inspection. If you intend to obtain financing, consult with lender or an attorney before cohmorlIcifig workyar recorcWFig yow Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE-OF FLORIDA I STATE OF FLORIDA COUNTY OF GI COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of r , 20 by this day of 20_ by S (Name of person acknowledgin ) (Name of person acknowledging) c (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification 41/ Personally Known OR Produced Identification Type of Identification Type of Identification Producedd KAREN S. NIE SEN Commission No. Commission# FF 166ftmi ion No. (Seal) o: My Commission Expires June 12, 2018 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.