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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE ii INFOMUSTBE COMPLETED FOR APPLICATION TO BE ACCEPTED ` Date: U I , 11 I Permit Number:x,111 'o RECEIVED Building Permit Application OCT 16 2097 Planning and Development Services PERMITTING Building and Code Regulation Division St. Lucie GOur.ty; t 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential _ PERMIT APPLICATION FOR: PROS D iN�PR EMI LOCATIC?N Address: C Legal Description: Property Tax ID#: • Q Z- ON Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: !LED-DESCRIPTION" a SZ Q Y- U3 n2�k\f\ Q t tO"'VCTIQN yINFOgWICIN � Additional work to be pertormed under this permit–check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof �a' Pitch Total Sq. Ft of Construction: , Sq. Ft.of First Floor: Cost of Construction:$ '��Q Utilities: —Sewer _Septic Building Height: 01NNER% .ESSE � � �ONTRAGTOR: �.�....i. w ...m. Name Name• Address: 'I ✓ Company: City: w vr ie Stater" Address: - Zip Coder Fax: City: State: Phone No. l ,^ Zip Code: Fax: E-Mail: u 1 d tub ' Phone No Fill in fee simple TW Holder on next page(if dif111en E-Mail from the Owner listed above) State or County License JEvalue of construction is 2500 or more,a RECORDED Notice of Commencement is required. � �'�' oro- � �SUPPIEML C©NS7?Of IQt� N >.A IIW� tMATI �� .�. DESIGNER/ENGINEER: ' _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City:t 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 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-1.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 r our Notice of Commencement. AA� Signature o Owner/Lessee/Co tr or as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA4, STATE OF FLORIDA COUNTY OF �(� ILE-d COUNTY OF The forgoing. t venAwas acknowledged efore me The forgoing instrument was acknowledged before me this�(� day of 20D by this day of .20_ by Name of person making statementJ Name of person making statement. "'Personally Known, OR Produced Identification Personally Known OR Produced Identification Type of Identification� Type of Identification Produced TL IN Produced A AA c� (Signature of Notary Pu ic- tate of I ignature of Notary Public-State of Florida) KAREN S. NIELSEN Commission No. 8 FF 1156 C mmission No. (Seal)'. = My commission Expire June 12, 2018 f REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED le—v-. 8/2/17