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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO vMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:(42' I Permit Number: V R Building Permit Application JUN 0 5 2017 Planning and Development Services Pi=P Y7I!7 1i\G Building and Code Regulation Division St. Lucia Cei;nth•, ,=L 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential — PERMIT APPLICATION FOR: • RR4PaSED INPRC+VEMENT LOCATIQN Address: Legal Descriptio Qc Property Tax ID#: f 131 fV t'J_ — ©r 3 Lot No.�� Site Plan Name: Block No. Project Name: Setbacks Front Pack: Right Side: Left Side: DETAILED DEkkIPTION O WORK _ 3 CQNSTRUCTIC}N INFORIVIATION Additionalwork to be performed under this permit–check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows Qoors Plumbing Sprinklers ' ''3` _ Generator Roof Pitch /�1 g p 1 .� 1?' ;: / �V m: Total`Sq'Ftcof construction: Sq. Ftaof.Fi, Floor: Costof Copstr�ction: $ Utilities: £_Sewer Septic Building Height: N i OW,[ ER/LESSEE CONT-RAGTQR ,e - I ariie F = Name O i Address:- ? cc6`a y - o J Alit' City: r QuC Q� State: P Address:`` ` `70 t— Zip Code:= Fax: City:__. rf- tt_ff Q State: t� Phone No. 77�"' q�15-9 42L-4,6 Zip Code:�'T�� Fax: E-Mail: Phone No -77� —1 7'– L19 1J Fill in fee simple Title Holder on next 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 SUPPLEMENTAL CQNSTRUCTI�N LIEN LAW,INFQRMATCQN DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: n / Address: Address: 11Z I City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable Name: Name: A //a, 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 commencin work or recordjng yourNotice of Comme cernent.A Signatur of Owner/Lessee/Contractor s Agent for Owner Signare o Con ractor/License Hol-41,r STATE OF f_ / u� COUNTY OFSTATE OF ORI C ivy) Z �/C6(J COUNTY OF FLORIDAk T v` �'T The forgoing instrument was acknowledge before me Thefor oing instrume t was acknowledge efore me this day of c�V VI(L ,20 by this 3 day of () 20_yby L I J .. �( (Name of persbn acknowledging) dLe No (Nam person cknowledging) yah No • O 19 � t7 { re of Notary Public-State of Florida) Z (SigrWure of Notary Public-State of Florida) c Personally Known OR Produced Identi ick iJn'3 I�etsonally Known OR Produced Identifi a8o v Type of Identification N Q Type of Identification m � o � Produced a Produced x w 2r. Commission No. (Seal) c q Commission No. (Seal) . I o a 3 ���iiiDDD o n_,tu o IL REVIEWS FRONT ZONING SUPERVISOR --PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW- REVIEW REVIEW REVIEW REVIEW DATE RECEIVED . DATE COMPLETED ev. 7/2014