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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �.�� �� E0 �- Permit Number: J '_ II 1 - RECEIVED Building Permit Application MAR 2 9 2018 Planning and Development Services Building and Code Regulation Division ST. Lucie County, Permitting 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential _ PERAPPLICATION FOR: PROPOS�(E����rD-IMPROVEMENT LOCATION: Address: ` 0 2J3 Coe Legal Description: �J `L Property Tax ID#: �J�j�-1 — c'� — �l --�(�/,_q Site Plan Name: Lot No. Project Name: Block No. Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: .� IUS�a1►��:Or.� c�� i���0�©1.� ��-QU�' A�'S ©tom _ e N�1�q�• LJ CONSTRw®rto �eper Oth �ti itiona �®rmeermit �ce �at �pp : _ HVAC _Gas Tank _Gas Piping .—Shutters.— _Windows/Doors _ Electric —Plumbing _Sprinklers _Generator Roof Roof pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: e� Cost of Construction:$_ 2� Utilities: _Sewer _Septic Building Height: OWN ER/LESSEE: CONTRACTOR: Name Name: Q_V p C- fc- Address: Q 1 1101,11 Company: V A City'�ni� —tom State: Address: d Zip Code: Fax: City: Phone No. Zip Code: State: O_lyh 1 —L Fax: E-Mail: Phone No. — 69 2 c? Fill in fee simple Title Holder on next page( if different E-Mail: lPubp L to Fob of from the Owner listed above) State or County License: -------------------------------------- If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. lb SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: 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 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:Yode failure'tq Record a Notice of Commencement may result irs your paying twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspecti n. If you inten to obtain financing, consult with lender 'r an attorney before -. commenci k or r rdin our Notice of Commencement. j E Signature of Owner/Les e / ractor as Agent for Owner Signature of Contractor/L•1U erlHolder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The f oing instrument was;acknowledg before me The for oing instrument wa acknowledge efore me this day of 1� 20 by this�day of Y 20by C c6 Name of pens making statement Name of person m ng statement Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced i 11 AA ti 1 r (Signature of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida) _ KAREN S.�QI,�I; SEN Commission No. Commission No. -, !! KAR N IV NIELSEN mission 15637 Commission i FF 115637 My Commission Expires My Commiss on Expires ;;`° June 12, 2018 REVIEWS FR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17