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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 4 f Date: ��A /7 Permit Number: 1 MCBMINUMMIXIMMWEV Building Permit Application MAY 11 2017 Planning and Development Services PCR101rTll-%1G 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 E Icer (� PRC?POSED IMPROVEMENT LQ'CATIC?N 'o" Address: 32,-15 MATMEurS R�) d2 38-70 Legal Description: � 12 Or ALL cZ I'35` 39 ISL 1A. OF L 1 z ©F LCT PSAND b ET Oe L07- I Co LE,-:%S CAMPR_ RAO QIP•82Rc. MNP a3 a N Property Tax ID#: 50 50 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF 1NORK . ,wilt ;-7,0&p,� %,�7 �s � .1/�?� Gam•--U rJdv,� Se Ct)�iSTRUNCTION INFORM�0.TION � �� � � � h� 7 x� � Additional workkto be r nertormed under this permit-check all that appy: HVAC Gas Tank ❑Gas Piping Shutters Q Windows/Doors LJN Electric Plumbing Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: SFt.of First Floor: Cost of Construction:$ ZU�ca r e� Utilities:]Sewer Septic Building Height: OWN ER/LESS`EE CtJ NTRACTOR .,�o. Name Name: C--' = to iw.o Address: .3Z7_S`/1�T/n&� lg Company: 46a' City: r-� /��G Stater Address: yS:2.4 Zip Code:3y991S_ Fax: City: State: Phone No. 2!,72,—moi'%Q _-4679` Zip Code:3y 9�y 9 Fax: E-Mail: Phone No. 7;7Z - 32 - Fill in fee simple Title Holder on next page(if different E-Mail: c��v L✓ �>_� Y'i .��i�C��c7 i�. from the Owner listed above) State or County License: dTl 06I.S If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTALCONSTRLICTIN 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: 1Nbt 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 work or recording our Notice of Commencement. `. s Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA i COUNTY OF 4 , � I(Cl6 COUNTY OF 161 ZJJC1r— The forgoing instrument was acknowled ed b fore me The forgoing instrument was acknowledged before me this day of 20 / by this day of 20 L'(1-1 by j6y r'� LAfor C �� LP uir, (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public-State of Florida) / (Signature of NotaryPublic-State of Florida) Personally Known OR Produced Identification V Personally Known OR Produced Identification -V/ Type of Identification ProducedType of Identification Produced Commission No. EN S. NIELSEN C mission No: (Seal) K Commission S FF 11563 KAREN S. NIELSEN .= F ire F June 12, 2018 ? a �A Commission;f FF 115637 Revised 07/15/2014 ° ac My Commission Expires June 12, 2018 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS