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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED. Date: /Zho/ Permit Number: 1 I �u := RECEIVED OCT 2 2017 • r, Building Permit Application PERMITTING Planning and Development Services St. 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: \Y� PRaPOSED INP OVEME T LOCATIG Address: IQ/D Gd ��c_�� /ait/l�S .�1� �T 191 kvecC- Legal Description: Property Tax ID#: 230 ?1' al - (30 71 600 5 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side:' I�Atffil DE�CaIP ION �F WOR+K• 6Lhz6v&<- . o/e fW1NGLLQ .41- /4Paf Ar-P4,4c,5- W f# iVL W CONSTR�UCTlO ' FO'RMATI©N: Z- 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 Pitch Total Sq. Ft of Construction: �L Sq. Ft.of First Floor: Cost of Construction:$ �G -,T Utilities: _Sewer _Septic Building Height: QWNER/LES EE CONT A QR: NameW SIT O C H E TT Name: Address:/><(,0 CCG ocji Pbk,bS City:,,,"-r Pi 6Fa e c State: 'ress Zip Code: 311948` Fax: City: State: Phone No.7z,1f. 379 * 4511 Zip Code: Fax: E-Mail:_11,&3 t Z-Qc i£TT &U di cosr> 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 G,EN LAIN INFORMATION: DESIGNER/ENGINEER: —Not Applicable MORTGAGE COMPANY: Not Applicable Name,. Name: — Address:'' ' Address: City: _ State: City: State: Zip: i' - ,Phone Zip: Phone: FEE SI R' E`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 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 con currency,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. gnature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDAt 1 STATE OF FLORIDA COUNTY OF 4 WCIG • COUNTY OF The forgoing instr e t as acknowledged efore me ' The forgoing instrument was acknowledged before me this day of 'C• 20 by this day of 20_ by AiRmy's �P fl Name of person making statement. ✓ Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Iden ' 'c tion (� Type of Identification Produced Produced (Signa ure of hotary Nota nature of Pub'' Si Public-State of Florida KAR N S. NIELSEN (Signature Notary c� �omrni ion t�<FF 115637 Commission No. -' *'- mission Expires Commission No. (Seal) 3 a ori: M June 12. 2018 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17