HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: No%� ®0
_ . t M�. RECEIVE®
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Building Permit Appli ation APR -g 2018
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue,Fort Pierce FL 34982 Cie ntYr Ft_
Phone: (772)462-1553 Fax: (772)462-1578 Commercial R Slfl
PERMIT APPLICATION FOR:
PROP®SED tNP:ROUEMENT LOCATtQ'N: �� ,..
Address: 1676 Dr Z& Z
Legal Description:
Property Tax ID#: ! ( "' Q` ( � �OOO _ Lot No.
Site Plan Name: Block No.
Project Name: Z-AX-36 I
Setbacks Front Back: Right Side: Left Side:
DET'AILED D'E�SCR+IPTIQN C�7F UI/OR�K:
@® STR+l1CT N1,NFORIVIAT!®N:
Additional work to be performed under this permit–check. a that appy:
_Mechanical _Gas Tank _Gas Piping Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction:/q� Sq. Ft. of First Floor:
Cost of Construction:$ y (9 . Utilities: —Sewer —Septic Building Height:
OWNER/LE-SSE : � CONT' QR: .;
Name s _ Name: Q ,/
Address: ICJ?�J � Company: �� JLC
City: '4,p
State:_ Address ��
Zip Code: 34 '� Fax: City: -) State•.
Phone No. Zip Code: Fax:
E-Mail: Phone No
Fill in fee simple Title Holder on next page (if different E-Mail
from the Owner listed above) State or.County License Odd 76
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. 0 60
SUPPLEMENT L C®NSI +IJr�TI®N.LIE�N LAUI/ IN'F4RM�►TIQN:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
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: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 'nspection. If you intend to obtain financing, consult wit lend or an attorney before
commencin rk or regWding your Notice of Commencement.
CM �
Signature of Owner/Lessee/Contractor as Agent for Signature of Contr se Holder , r
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STATE OF FLORIDZ STATE OF FLORIDA A CL
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COUNTY OF m� COUNTY OF fiVG�� =oma z
Eu?W m� m
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The forgoing instrument y[as cknowledge efore s`c3X The for oing instru nt was acknowledged befo L z
this day of 20�rby ME m this day of 20 by a Lu
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(Name of person acknowledging) (Name of person acknowledging)
liG .
(Signature of Vtary Public-State of Florida ) (Signature of Nota r ublic-State of Florida )
Personally Known OR 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
lev. 7/2014