HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �. _� Permit Number: � �. D 6?A
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Building Permit Application
Planning and Development Services MAR 2 3 2018
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)4627-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR:
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PROPOSED,IN°PROVEMENT LOCA lON
..E
Address:
Legal Description:
Property Tax ID#: � (�-�- 1903 r J(Do -S Lot No.
Site Plan Name: C 6C E 932 - !'z_2Ac\JkQ6A N Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION aF WORKt
.EMO i ri'ra2 tc2- LA�7 SPkc-0 Azox� z- G�F_1 t_�to
"CONSTRUCTION INFORMATION
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Add
itiona-1.work to be perFo—rmed under this permit-check all tat appy:
'Mechanical _Gas Tank _Gas Piping Shutters _Windows/Doors
Electric _Plumbing _Sprinklers Generator _Roof Pitch
Total Sq:.Ftof Construction: l LQC Sq. Ft.:of f first Floor: `(Poo
Cost of Construction:$ Z%000 Utilities: Sewer Septic Building Height:
OWNERAESSEE
TRA CON
.
Name V_kU_Pda14_ o NamtAk
Address: (33 WN-rGe_1_-, ip- Company: Iv
Address:Stater Me
p
5E A, I& IU�I_G JPcvy�
Zip Code: Fax: . City: VSl. State:f L_
Phone No.S(D t 524 VQ 2241Zip Code: 3Ltq,5L Fax:
E-Mail: &)DJ\)i (> a- Phone No 772
Fill in fee simple Title Holder on next page(if different E-Mail E&SS i'
from the Owner listed above) State or County License �� 12SS34�
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
Sl1PPLEMENTAL CONSTRUCT-I.ON,LIEN LAW INFORMATION!
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Addres
City: State: State:
Zip: Phone Zip: Phone:
.FEE SIMPLE TITLE BOLDER: of Applicable BONDING COMP Not Applicable
Name: Name:
Address: Ad s:
City: ity:
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 work or recording our Notice of Commencement.
Signature o e Le see/Contra or as gent for Owner Signature of Contra r ice a old
STATE OF - STATE OF _
COUNTY OF COUNTY OF
The forgoing instr ent was a knowledge"e �:' 'e The f rgoing instrument was acknowledge e F
this day of 20b % t= this day of /�) , `,�11�, 20 1Xb 9d%
o �
/� /` o X�a81
(Name of pe son acknowledging) o��< (Name of person/acknowledges U=
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(Signature of o ary Public-State oV Florid ) " eA Q (Signature o otary Public-State o Florid - yN
(ON y
Personally Known / OR Produced Ide y Personally Known OR Produced Identification
Type of Identification 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.