Loading...
HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED tp ,,11 Date: Permit Number: 1 O Vql� © RECEIVED r'ar�ro_ Building Permit Application APR ®2 2018 Planning and Development Services Permitting Department Building and Code Regulation DivisionYI St. Lucle County 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: �. . Address: Legal Description: Property Tax ID#: 2-t oq — I t — WM - M—),9 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION, F"WORK � P 6 vYT Z, I CONSTRUCTION INFORMATION Additionalwork to be nertormed under t ispermit—check all apply: HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors ®Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: SFt.of First Floor: Cost of Construction:$ �i`i'Ul� Utilities: _Sewer E]Septic Building Height: 0, NER/,LESSEE CONTRACTOR: �� NamMe:5�'_�) c- LLC Name: AddrCompany:' L City: State: Address: OlVZip Z9Fax: City: , ( c� tate:� Phone No. Zip Code: �-E Z Faccx:� �� ( — E-Mail: Phone No - — O_J Fill in fee simple Title Holder on next page(if different E-Mail: _ LS Q Cc iJ L,6yyl 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 LIEN LAWINFORMATION. 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. I 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 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 commencing work or recording our Notice of Commencement. Signature-Jof\Owner/,Lesse Contrac as Agent for Owner Signat�u e f Con ra for icense er STATE OF RIDA STATE OF FLORID COUNTY OF S�- COUNTY OF 6' L ouy The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 7_day of_ OIL 20/& by this qday of ,i.,L 20� by Name of person making statement Name of person making statement Personally Known OR Produced Identification JL Personally Known OR Produced Identification o< Type of Identification Type of Identification Produced D,_ Produced PC- U (Signature of Notary Publi -State of FloridaQ m (Signature of Notary Publ State of Florida) �p�w Commission No. (Seal) = ir �°XUJ o Commission No. (Seal). N o:M uf X zom 3 occ 2'a ePr a o E o REVIEWS FRONT ZONING PLANS VEGETATION SEATURTLE MAN �V� COUNTER REVIEW REVIEW REVIEW REVIEW RE v, ID �� DATE 1 co C5 X Z; RECEIVED ��.•t;��.�,� DATE __ ;. -•Q;: COMPLETED Rev.8/2/17