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HomeMy WebLinkAboutBuilding Permit Application C" ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I %� Date: �1' Permit Number: l l) �/��!I 1� , w ECEIMED Building Permit Application FEB 2 1 2017 Planning and Development Services PEPFOF TI14G 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: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: ' 1 V r c7 Legal Description: Property Tax ID#: I �y '.yM,) �—,—� `� Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION,OF WORK: /l-I C Gt4AGeod f L C IC6 ; Xa-r)v.� . S f 4-A 6�4T G�'0�, /SEA-65P- CONSTRUCTION`INFORMATION:. Additional work to be pertormed under t is permit-c ec all that apply: HVAC _Gas Tank —Gas Piping _Shutters —Windows/Doors _Electric _Plumbing _Sprinklers Generator _Roof Roof pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: iJ Cost of Construction:$—�T, �c�" Utilities: —Sewer _Septic Building Height: OWNER/LESSEE CONTRACTOR: Name , -o J i a 0 . Name: wA,) © f- I A--) Address: S✓ `r e Z 1 - Company: Je i �ef- /y C City: r o. [A State:�� Address: T 41-7C ' Zip Code: f 2- Fax: City: V"- I A r'L i I Stater_ Phone No._��?S- , N 11,6,`I Zip Code: 13 3//13 L[ Fax: E-Mail: Phone No. b Fill in fee simple Title Holder on next page(if different E-Mail: 9 e PA,,.J k�g!2a co P1 from the Owner listed above) State or County License: C A-(- If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION. DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: 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. 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 wo' r recording our Notice of Commencement. s Signatue o ner/Less a/Contractor as Agent for Owner Signature of ontractor icense Holder STATE F FLORIDA STATE OF FLORIDA COUNTY OF Lt._ , L L4— 'e, COUNTY OF l- t - — ( 1 A \) 2 The f oing ins tru t as acknowledge efore me The for oing instrumgat wa acknowledged efore me this C day of YcJ c �( 20 V�by this��day of Yr-/ Ir by t -'k_ 0 --y,/ a 111119— r—-A,-\ --I (Name of person acknowledging) (Name of person acknowledging) (Signature of N 'c� FFF�4giC ) (Signature o otary Public-State of Flor' @Z Per o Atop,1p-OtosS%ON# Olden Y ®g RPe�d°'Z HEFM19A � �ye Iden ication Personal) Kn uced q(�iL+�'�i n Typ .I atiolRRlc C0� Type of Id • Fw+ EXptRES Com i 0 (Seal) Commissio qp7 398.p153 Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS