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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ��� 17 Permit Number: t="-5 RECEIVED _. ,..w Building Permit Application SEP 2 9 2017 Planning and Development Services ,,_ PERMITTING Building and Code Regulation Division St. Lucie County, FL 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (7.72)462-1578 Commercial Residential PERMIT APPLICATION FOR: �P✓„�/;Hon P'RO'POSED INP OVEMENT L©CATIO'N: Address: /1.01 114f/es 8/✓e.1 Se,7fm 6'eac/ . F V7,7 Legal Description: ­41eir/�S �SlonA LI'IC• [ ���y`/.37� Property Tax ID#: //5_0,?1-'5'Ol-A/7tL 000" r Lot No. Y? _ Site Plan Name: �*t§/s1 Block No. Project Name: Setbacks Front Back: Right Side: Left Side: D' AILED ® -CRIP 10 OF ' OR!K Coeb /a�e tir o&An ane, y,cnr ova/ O1e gS S>� 4Pe jor e GY11 fJa��cti 1CONSTR�IJCTIRWJRWEJIFMRMT,,:ATI'ON: Additional work to be pertormed under this permit—check all tat appy: _Mechanical _Gas Tank GatPiping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction: $ /719'0 va Utilities: Sewer _Septic Building Height: pFt 0 SPIN" CO.N � Name Oro/' G:..,. ei" �r»4r� Name: Gro jr? �f�ii Addre''ss: 8 Ordlke r�r "'~'' = i4 ,.Company: Grp City: �..., �Tvaif' �._..�........,_ .. ......� State:FG. Address:Me.- Zip Code: 3 y996 Fax: City: ,32n Ste, State: FL Phone No. 1/0Z/- y3 06')- 7 Zip Code: 7V?-f7 Fax: 77) ',2 3;-���!/ E-Mail: Phone No 772IdO-37�� Fill in fee simple Title Holder on next page(if different E-Mail A Ict ;7o L4 Pw e (? ya4go- eO.,, from the Owner listed above) State or County License ehlcA2 5 7TH if value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL ON,, 00"TI®N LIE=N LAW INFDRMATI®N: DESIGNER INEER: _ Not Applicable MORTGAGE COMPANY: pplicable Name: Name: Address: '; ''s ' ' J Address: City: State: City: State: Zip: Phone Phone: FEE SIMPLE:TITLE,HOLDER: _Not lc�ble DING 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 reyiew:.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 reggrding your ice of Commencement. 'lop Ile Signature of Owner/Lessee/Contractor as Agent for.Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF ' , 0,T, COUNTY OF 4. [ I The for oing instru ent w s acknowledged before me The f r ing instru ent w s acknowledge before me this'n day of 20-1-q by this day of 20 by (Name of person acknowledging) (Name of person acknowledgin ) c�— (Signature of tart'Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification ✓ Type of lclentlfieatio Type of Ident'fi Produced � KAREN S. NIELSEN "21%,, KAREN S,. NIELSEN J`tilpr ye(�i ;� mission# FF 115637 Produced Commission# FF 115637 '-• ;= . My Commission Expires =* "' M Commis Wgn }�pires Commission No. . oP.•` (SRAh)e 12, 201 8 Commission No. '= P°c y June 1JJ'LU4 8' E REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION.- SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW '' "REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.