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HomeMy WebLinkAboutBuilding Permit Application S4JPPLEMENT�A►L C®NSTRkIJCTIONIEN 1AWI 'FORMATION: — pp DESIGNER/ENGIN EER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: /C4?6 � Name: Address: S AJ S Address: City: P,G/1VIAGe State: City: State: Zip: ADZ/ZJ Phone ?03 -7S7--,F .3:g 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 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 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 commencin"o*--py-Mcording your Notice of Commencement. Sign ture of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA . COUNTY OF S-f- roc - COUNTY OF The forgoi -instrument was cknowledged before me The forgoing instrument was acknowledged before me this I�ay of 20 fe by this day of 20_ by ftR�2 y goAA64-/ (Name of person acknowledging) (Name of person acknowledging) (Signa ure of 9ary Public-State of Florida) (Signature of Notary Public-State-of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identj ication Type of Identification Produced ,-OL. ©6—2 7 Produced GARY BAKER Commission No Cn ion No. (Seal). O n EXPIRES:AprU 21.Lp21 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. /2014 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO•BE ACCEPTED Date: • d' Permit Number: 7� _ Building Permit Application MAR 21 ..2018 Planning and Development Services t7 19 9XJ Building and Code Regulation Division T �' 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: PROPOSED hNPROU'EMENT LOCATI®N: Exam Address: 5_-W PACI��_D f iAueS ('I2el-E, 7.1,�kec-_ , J Eq Legal Description: Property Tax ID#: o� • c-0 0' 00a. OD 06 Lot No. Site Plan Name: Block No. Project Name: 111 1 n Setbacks Front Right Side: Left Side: DETA�IL�E�D� DE�SCRaIPTION QF WOR ' . ' O l Z51W �— r CO'NXSTRUCTI®=ffl1F@WIA I®N Additional work to be performed under this permit–check all tat appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction::/ 0 Sq. Ft.of First Floor: Cost of Construction:$ VOo Utilities: —Sewer —Septic Building Height: �' OVIINER LESS E: Name a�� b: Name 4 ti.•w _ _ �;: Address: S'-701 V;s- City: StateJZ71 'k+ ;�Qddre,ss' Zip Code: Fax: _ "City: "` ` ` State: Phone No. 77Z _ y(oK :79-?& Zip Code: Fax: E-Mail: bsrg2 -,�oADp,Cam• 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.