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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �.{ Date: ` Permit Number: M., M- 17, 1. M Building Permit Application JUL 18 201? Planning and Development Services PERMI:'Ti;�.r= Building and Cade Regulation Division fit• r uois County, FL 2300 Virginia Avenue,Fort Pierce FL 34982 /� Phone:'(772)462-1553 Fax:(772)462.1578 Commercial Residential G' PERMIT APPLICATION FOR: —TI t l < Mw Address: L/�3 p��J P� lu fa � 1e � l 5 YW Legal Description: 4&1J) Lf.X) ff)}( .4d Property Tax ID#: lea/ 608 01,51000'2L Lot No. Site Plan Name:, Block No. Project Name:. Setbacks Front Back:' Right Side: Left Side: Fh Ol1� 1 e— Rotten 4P j9A I(N ee 0 ' �,�� t��� W t � Ad ditiona workto a pe orme und er this is permit—check all that app y: 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 $ Utilittiie�sg: Sewer Septic'• Building'Height: Name P-A i Na t}au� C. �� 1 j ., i me ori. ' City: State: Address: Zip Code: 3q-q Fax: A city: dr", 'Pl e -Ge. State: . Phone No. Zip Code: 3#11q Fax:7 L 514',�rL77 E-Mail: Phone No 772 /6 ogq Fill in fee simple Title Holder_on next page{if different E-Mail r © a from the Owner listed above] State or County Licensed 1 m if value of construction is 2500 or more,a RECORDED Notice of Commencement is required. 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: I MM Address: Address: City: city: Zip: Phone: Zip: Phone: OWNER/CONTRACTOR AFFIDVIT:Application is hereby madeto 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 thepermit 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 Oe first inspection. If you intend to obtain financing, co ult with lender or an attorney before COMW(epcing work orlrecording your Notice of Commenceme t.J 17 Signature'off Owner/.Les a/Contractor as Agent for Owner Sign ture of Contractor kens Holder. STATE OF FLORIDA STA E OF FLORIDA COUNTY OF COUNTY OF �T The forgoing instru nt as acknowledged before me The Vday ing instrument was acknowledged before me this day of 20 by this of 2017 by L E L C,::)25Q9 17 &A/ (Name of erson acknowledging) (Name of person acknowledging) (Signature of Notary P lic-Stake of Florida) (Signature of.Notary Public-State 6f Florida) Personally Known ✓ OR Prod sown OR Prod ed,�dWIDication cnNNir I p come A�1►� PUB i Type of Identification • ' ''. ` Y tification ���•, Notary PubllC-S t of FIorI Produced �s Notary Pubtic,•,S Isr#dtl -• ••= Commisslon �� :• Commission F 80098 +: �.g, .�;� My Comm.Erplrs J 29.210 aa ((]] My Comm.Expire Jul 29,2020 , b Commission No. F7 8Do 9 8ondirdthroephNztt na�lydfd1�1155A No. E 00 ��" �� BoadedthroughRN k : ..:_ REVIEWS FRONT ZONING ' SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW. DATE - RECEIVED DATE COMPLETED ev.7/2014