Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ►� '`� _� Date: ALO • Permit Number:_�� O l t) ! Building Permit Application OCT 6 2017 Planning and Development Services PERM. 11 ING Building and Code Regulation Division St. Lucie County, FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: PRCIPOSIED 1NPR0VE N 'WCATI'ON �g Address: /erc-e 3q q41 WS Legal Description: © S 6K /J I — L-© 7 d g —/95/c Property Tax.ID#: f Y3 Do'_2 C/D©S_ C)QO "' l Lot No. LO'T Site Plan Name: Block No. i Project Name: Setbacks Front Back: Right Side:' Left Side: DETAILED DESCRFPTION C3F WC►RK• M . CA a,4Atv, GYS� f� S —Zbr 'S 1 ,CC)N5TRUCTIQN [NFORIVIATIQ'N Additionalwork to be pertormed under this permit—check all that appy: _Mechanical _Gas Tank _Gas Piping _ShuttersIndows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ d 000 Utilities: —Sewer —Septic Building Height: QINNERLESS,EE. �°a 'ON TRACTQR :. Name LD T�RI_GD Name: `F + Address: OSI c Company:u City: T ,el er(--P State: Address: " ` - - Zip Code: C/ Fax: City: State: Phone No. Zip Code: Fax: E-Mail: 007/14 Phone No Fill in fee simple Title Holder on next l9ge( 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. Sll:PPLENIENTAL C(7NSTRUCTtON I:IEN LAW INFQR`IVIATIQN DESIGNER ENGINEER: Not ' DESIGNER/ENGINEER: _ Applicable MORTGAGE COMPANY: mot Applicable Name: Name: Address: - Address: City: State: City: _ State: Zip:, Phone Zip: Phone: FEE SIMPLE-TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name::- L'b l' L/� Name: Address: b Address: City: 41 City: Zip: c Phone: qOZ—&S:5 .S' 3 !-1 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�here6y 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 nonresidential 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. ad Signure of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORID STATE OF FLORIDA COUNTY OF �(�,t�, COUNTY OF The forgoing instru ment was acknowledge before me The forgoing instrument was acknowledged before me this day of ( ; 2011 by this day of 20_ by o.� Name of person making stat ment. / Name of person making statement. Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification Type of Iden't'{fication Type of Identification Produced All AAI Produced (Signature of Notary Pu )lic-State of Florida (Signature of Notary Public-State of Florida) �a�� �,�� KAREJ Commission No. Com S. NIELSEN �3)on itFF 115637 Commission No. (Seal) My Commission Expires °a?a P June 12 2018 REVIEWS FRONT ZONING SUPERVISOR ',.PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 8/2/17