Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE YMFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 Date: K& Permit Number: l VE D APR 10 2097 Building Permit Application P�P��ITTiraG Planning and Development Services _ St. LUcie, CoL!n'v. Fl- Building 9 and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: 772 462-1553 Fax: 772 462-1578 Commercial Residential PERMIT APPLICATION FOR: 'k, 'c PROWS,R I'NPRQ1/EM::ENT L®CATION: Address: 9,92 13 to. 17'.- Legal Description: Property Tax ID#: - V(A " con Lot No. Site Plan Name: S4y&6.NA-CL A (J iia-1_ f Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAI�LE'0 DEA CRI�PTION QF 1NOR�K: COfSTR�l1CTION I'NFORII�fAT ©N: Additional work to,be performea under this permit-check all that appy: _Mechanical _Gas Tank —Gas Piping —Shutters- _Windows/Doors: Electric _Plumbing _Sprinklers _Generator' _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ �00 CD-0 Utilities: —Sewer _Septic Building Height: OWNER/LE�.SSEE CQNTRAC1'�R: Name I&AAOAq'aq- Name: Address: R,,213 G(-, �'�� Fe of ��4_, Company: cc-C• City: State:LC Address: UaS tFr o.G PA/3 - Zip Code: Fax: City: State: C Phone No. ?g- k? S-3Y Zip Code: ,3,-(4 S,Z Fax: E-Mail: Phone No -•o` a`f Fill in fee simple Title Holder on next page(if different E-Mail 0 ) OC,4-1 4e-ken'.ecL' Cd'W-7 from the Owner listed above) State or County License cid M2 lEvalue of construction is 2500 or more,a RECORDED Notice of Commencement is required. I'PPLEMIUIEiUT4L CQN�STR+tJi f'I®N LI"iE(�! t W fiiUjFOR11/IAT"1®N: 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: 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. 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. Signatu of Own essee/Contractor as Agent for Owner Signature of Contractor/C cense Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF ��„�,(E, COUNTY OF d' The forgoing instr e_nt was acknowledged before me The forgoing instr ment w s acknowledged efore me this�day of 20 by this day of 20 M by ' 0 , C (N a of person acknowl KAREN S. N I E LS E N Name of erson ac nowl d'Fi gc, p � Commission k FF 115637 a Commission t! FF 115637 a �e My Commission Expires My Commission Expires �• ,„ June 12, 2018 June 12, 2018 (Signature of Notary Public-State of Florida) / (Signature of Notary Public-State of Florida) / Personally Known OR Produced Identification V Personally Known OR Produced Identification e/ Type of Identi ' tion Type of Iden fication Produced ProducedLu Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. //2014