HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE
II INFO
rMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater �� 1� ! Permit Number:
...w Building Permit Application OCT 12 2017
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 /
Phone: (772)462-1553 Fax: (772)462,-1578 Commercial Residential (r
PERMIT APPLICATION FOR:
PRaPOSED NRROVU' ENT l.a,CATIC}N °'
Address: I t ffiby)
Legal Description:
Property Tax ID#: 3>0 VT - _cp - V:S 1 0 0 0- Lot No.
Site Plan Name: Block No.
Project Name: S+ • kjnc, arden S.
Setbacks Front Back: Right Side: Left Side:
DETAlIED DESCR)P7ION:f3E WORK.
a
�e og e cm v ( C-e- 50 a h r 2.t2cty c
CONSTRUCT)t7N [NFORM'ATIOfV N `
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Additional work to be pertormed under this ermit-c ec all that apply:
—Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
V Electric Y Plumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:. .
Cost of Construction: $ `OD Utilities: —Sewer Septic Building Height:
OWfER/LESSEE.
ONTRAC�OR
Name 1(tx) DaUIs Name:
Address: add i Ito Company:
City: Oft Si �e State:_ Address:
Zip Code: S449 Fax: City: State:
Phone No._� qi� I(- o Zip Code: Fax:
E-Mail: i::;L SAC'C2S Phone No
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.
SUPPLEMENTAL CONSTRUCTION 1 LAW INFQRlVIATIQN
DESIGNER/ENGINEER: _ Not Applicable MORTGA E OMPANY: _Not Applicable
Name: NaMe: ��� F61go ornP_ or c?g
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: V 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 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 the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORA@ ���'
STATE OF FLORIDA
COUNTY OF = �¢- ?:'l COUNTY OF
The for ping instrument was acknowledged before p The forgoing instrument was acknowledged before me
'this day of 20 17 by a this day of 20_ by
o m s m
z ��a
(Name of person acknowledging) Q (Name of person acknowledging)
A ffl
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(Signature of ary Public-State of Flo da ) P (Signature of Notary Public-State.of Florida)
Personally Kno OR Produced Identificati4/ Personally Known OR Produced Identification
Type of Identificat Type of Identification
Produced Produced
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.