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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO-MUSTBE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ' l' I Permit Number: RECEIVED - AUG 2 9 2017 �. Building Permit Application Planning and Development Services PERMITTINGSt. Lucie County, FL Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: EI PR PPOS,ED I'NPR®UEM[ENT L®CATION; Address: ti ' ��T . Al T C Legal Description: Property Tax ID#: Q CO �' V �� ' �J(=llJ' Lot No. �� Site Plan Name: Block No. Project Name: Setbacks Fronts , Back:�_Right Side: Left Side: ' DET I ED D SSC +IPT O!N O ORK• ve a C®N�CT ®' INF®a ATION• Additional wor to a per orme un er t i.s permit-c eck all that appy: _Mechanical '_Gas Tank Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Pitch s - Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction: $ �/ S Utilities: —Sewer —Septic Building Height: OWNER/LE�S�SEE• CONTRACTOR: Name S e " Name: AdcJress s�8 ` R µCompany;r - © C� City: o `. lD`cr e e State:E Address:�!k Zip,Cod �- _ .Fax_ � 'f` :; Cit ����j�- �/`f'`c� ,' State: �f�-- Phone lNo... E-Mail: Phone No �7_2 vZ- Fill in fee simple Title Holder on next page (if different E-Mail from the Owner listed above) , State or� my en If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUFRLEMENNA:L C®NS'TR'-UCTI'®N LI N MARM fNF 'R A VTION: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: 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 recordingyour Notice of Commencement. 6 Signatur f Owner/Lessee/Contractor as Agent for Owner Sign atu f Contractor/License Holder STATE OF FLORIDA 'Z STATE OF FLORIDA COUNTY OF COUNTY OF The :qday ing instrutentwas acknowledged efore me The fo ing instrum nt was acknowledged before me this of 20 1 1 by this day of 2011 by (Name of person acknowledging) (Name of person acknowledging) AA (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification_�� Personally Known OR Produced Identification Type of Identifi n Type of ldentiflgoion Produced Produced G Commission No. mmission No. KARE • t IELSEN KAREN S. NIELSEN `�= ;.�;�� •,•. Commission k FF 115637 -• °= Commission N FF 115637 zs - % ,Ce. MY Cc mmission Expire June 12 ys REVIEWS FRONT "' J n LANS VEGETA COUNTER REVIE VIEW REVIEW REVIEW REVIEW DATE RECEIVED -7] DATE COMPLETED ev.