HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r `
Date: Permit Number:__ n -0636
rr I
RECEIVED
Building Permit Application
APR .O
2 7019
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County
2300 Virginia Avenue,Fort pierce FL 34982
Phone:(772)482-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the and of line
Address: O&QtOSIO, L60112,
Legal Description j a_k�
PropertyTax ID#: 1cavi�e_ (ac p�?s!C� Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side.
rl- 'f idea cel -}C A"-e oj-�i �-
i na work to be erformed unclert ispermit=check all appy:
HVAC Gas Tank ❑Gas Piping Shutters I3 Windows/Doors
Electric Plumbing []Sprinklers Generator g Roof Root pitch
Total Sq.Ft of Construction: /_�. 5 Ft.of First((Floor:
Cost of construction:$ �( `D0 UtilitiesSewer 0Septic Building Height:
Name '-AiY f Name: ' �5
Address: � �F' �p '
1/.4
city: lu N-e—
State:F2_, Address: � � r ,1-
Zip Code:. Fax.0-70- q - _f)Z__7 City: Stater
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Phone No7717WE, ` �. Zip Code: Fax: 2-3q�_Cfl?
E-Mail: C` 17f" Phone No.
Fill in fie simple Title Holder ext page(if different E-Mall• ,(�- r?e
from the Owner listed above) State o County License: G
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
rNERANGINEER; Y 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 Count,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 5t 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 obtal'n financing,consult with lender or an attorney before
commencin ork or cordin your Notice of Commencement.
Sign o er/Lessee/Contractor as Agent for-Owner SiMlPf Contractor/License Holder
ST F FLORIDA VAtE OF FLOR'IDA
C NTY OF maif COUNTYOF • U A C_i••e
,The forgoing instrument was acknowledged before me The forgoing instrum it wqs acknowledged before me
this' day of Jhir,( 2010 by this day of t 20—W by
Name of perso aking statement Name of person making statement
Personally Known v OR Produced identification Personally Known ',"- OR Produced Identification
Type of Identification Type of identification
Produced Produced
'+ CRAiG A.ORO SMANs CRAIG A.GR AN
8 M
MY COMMISSION PF99M 3'. •*; MY COMM1 ION
(Signature of Notary Public-State I A ',Wgnatu a of Notary Public-State I , r-exp!Res May 11; EXPIffim Mayt
Commission No. (seal) Commisslon No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17