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HomeMy WebLinkAboutBuilding Permit Application All APPLICABL INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 4 0/Q Date: Permit Numbe : G"'---- : � �. r ED63 APR - 3 2018 �.,..�, � -...._ .��..� Building Permit Applic pip Aitting Department Planning and Development Services St. Lucie C Building and Code Regulation Division nty, FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: P=RQPOSfD 1NpRQVEME{ T L©CATf I .. . ;.. w Address: �-' e �" �- e�,� ��� .I 2 Legal Description: C ", Property Tax ID#: .T::�1AdIF Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION t3F e r, e, ''S "'T tNl=ORNiAT10N` 5 q ;ems -..u_. -.. s Additionalworkto a performed. under this permit check�all t at-'app y: Mechanical' Gas Tank . . Gas Piping Shutters i Windows/Doors _Electric, Plumbing —Sprinklers —Generator I/Roof Pitch Total Sq.:Ft•of Construction: Q 5 Sq. Ft..of.First Floor:,.cost of Construction:$ �Y-l 2. ��� Utilities: —Sewer —Septic` Building Height: f7WNE0f LESS E. ft 2 x 1IONTRACTOR" 3 u .ter a .. .ia .'."a , Name{ra A + 1,5 bes on -0'Q I w C_ Name: Address: Z �il 1 Cc. I IA G(nn l,,��T City: �iT, ��ercG State: r- Address:' a In 2 S L' CpAr—c , •dot - Zip Code:�3 LI q f( 2 Fax: //�.� City: �' �— State: 1 Phone No. "7 U 3 -S 1 3 '6 tp`'/ Zip Code: 3�-t�i Z Fax: ,c,I * E-Mail: Phone No`� Z �1 �-�,` S_2. Fill in fee simple Title Holder on next page(if different E-Mail r C'k-' G LA) -V LC C.G k-w Q C'✓v`r- from the Owner listed above) State or County License_ If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENl`AU CONSTRUCT10N UI�N LAW IN„ QRMATIQN � - DESIGNER ENGINEER: z ` / _Not Applicable MORTGAGE COMPANY: _ Not Applicable Nature. ''`;�: Name: Address: Address: City: State: City: State: Zip: 'Phone Zip: Phone: FEE'SIMPLE:TITLE'HOLDER ; Not A Name: pplicable BONDING COMPANY: Not Applicable ,; ` ' 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 commencing work or recording our Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent f - Signature of Contractor License Holder STATE OF FLORID - STATE OF FLORIDA [ COUNTY OF m COUNTY OF .dCyO ' 2 M •. The forgoing inst ent vias acknowledged before rmn The fo oing inst ent was acknowledged b this, day of 20 by w zS this day of 20 a ���� � TTS a�Td•4 �p LL (Name of person acknowledging) 11 a (Name of person acknowledging) a (Signature of Not rf Public-State of Florida ) (Signature oftry Pub ic-State of Florida) Personally Known�R Produced Identification 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. /2014