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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED rr Date: / Permit Number: I�.Co C14-12 UAL A Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Phone: (772)462- _1553 Fax: (772)462-1578 Commercial - Residential r - - al � PERMIT APPLICATION FOR: r R Address:,-7 o,_+ V e_ Legal Description:L✓ k e_f_,_)o od Lo l c� ,�/ _ �o2s /� //Coy �020 - Property Tax ID#: d(-L��(� ^© l cl '? _000 q Lot No.� Site Plan Name: Block.No. Project Name: Setbacks Front Back: Right Side: Left Side: w ecZ �- (c� -moo 'erf e.j Pciv A `e dJ Additional work to be pertormed unde this permit-c ck all t at 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:$ Utilities: —Sewer —Septic Building Height: u NameSSv I J-k W i 0'-JName:Name: �-l/el/� Addr'esss:qo" - LA kte 6 i tzr �o k L Company: Ak ; 'e City:pec c(e. fla_ State: Address:.&ofes,.�A�a La.L e Zip Code:�?.3 C/I/z Fax.- i ity: 101991- ,Sqv✓, 17zl_Geci C' State:_z'_4z Phone No.%-f-f " 7-371'e S Code: SY 9,5-7 Fax: Z O E-Mail: Phone No 27? Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County Lic nse 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: Address: - - - - Address:-- city: ddress:-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. Sign ref Owner Lessee/Contractor as Agent for Owner Signature of Contractor/License H e STATE OF FLORIDA STATE OF FLO" � COUNTY OF �,(Q(-J COUNTY OF _-37 The forgoing instrument wa acknowledged before me The f r oing instr Anent was acknowled ed before me this s `day of S 2017 by thi�day of 2 by (Name of person acknowledging) (Name of person acknow edging) (Signature of Notary Public-State of Florida) . nature of Notary Public-S to of Florida) Personally Known OR Produced Identification V Personally Known OR Produced Identification Type of Identification Type of Identifica 'on Produced L- ,;,EYP, ed .mo=o+ •`c+'s DEANNA WATER "" 0kfkUl ���IoOg�J _ • *SeComm.y Public-State of F tp. PNNpIN,,oiFlosida IG6M ission No. ;e#Sta eC 2p 20 5 Commission No. CExpires Nov 8,2018 larl ' sD , OF FL�p` Commission #FF 160825 So°aY °,`��•- No oma.DxP1te FF y�7249 n,- ,tiii ` l a� pSS i Cot„ REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATI •�9- QTURTL- y MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVfEW REVIEW DATE RECEIVED DATE COMPLETED ev.