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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /q Date: 1—� Permit Number: �J RE CF VEf?p� Building Permit Application APR 17 20V PERMITfiNG Planning and Development Services ' St. Lucie Ccunt; FL Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X PERMIT APPLICATION FOR: �.��IC,IA PROP©SED INP'ROUEM'ENT L®CATION: Address: _ C�C� / V Legal Description: L C k)r.Joa W pc�r4-el !-Ott. '81'e �?3 Property Tax ID#: fJ3 /3 Lot No. Site Plan Name: Block No. /3 Project Name: Setbacks Front Back: Right Side: Left Side: D TAILED DE�MCRI'PTION ®F ORK: kLkh lef CONSTRU,CT10. WS FOMR ATI®N: Additional work to be performed 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: O Cost of Construction: $ 4/00 Utilities: —Sewer _Septic Building Height: OWNER/L=�StSEE• CONT ACTOR: Name 1,4 vz`r-. e,'�7 'hOr:CAP Name: I z:L tt� . Address: `t7o(O WeJT- Company: ,,,1/e" c~tu�L'(-err Cit , State Address: 6 SOO n Zip Code: Fax: — City: Stater Phone No. Zip Code: Fax: E-Mail: Phone No Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License �G ib 0 O '7 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLE iENTAL C«ONSTRIJCTI®'N LIEN LAYJ 1!I 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. r Sign ure of Owner/Lessee/Contractor as Agent for Owner Signa ure of or-tractor/License Holder STATE OF F LO RI QA I STATE OF FLORIDA COUNTY OF —it ti 9C°�I�s COUNTY OF The for oing instru ent wa acknowledged before me The for oing instru ent wa acknowledged before me this day of 20jT by this day of 20i, by (Nam person acknowledging) (Name of person acknowled >ng (Sigr�atu`rb of Notgry Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification ✓ Type of Identif' tion a of Identif' ion ,.Pa.oB,n,; KAREN S. NIELSE Produced commission FF 1156 7Pr duced My Commission Expires v;"". I< REN S. NIELSEN ";'of"n e` '- �rSQa��ion FF 11 5637 Commission No.� �f %,,,,,; (SealPune 12, 201 8 C mission No. co My Commission Expires June 1 2, 2018 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. /2014