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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED "� 1 Date: T� Permit Number: RECEIVED Building Permit Application I APR 12 ?018 1 Planning and Development Services ST. Lucie County, Permitting Building and Code Regulation Division -- 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 5�'\ e PROPOSED IMPROVEMENT LOCATION: Address: a le aq L_,0 Der C_x Legal Description: S V - NO+ k 3'61g - a$ 51 Property Tax ID#: Ma5— `T 01 — 0 1-19— 000— 1 Lot No. 3 Site Plan Name: Scu�v\r\cL_ C_,ku.b Block No. i Project Name: loam C"C,✓- Lt— Setbacks Front Back: Right Side: Left Side: [IDETAILED DESCRIPTION OF WORK: �G 'Fj&Ni(- IC. `-L'L, �v1C��'-V�t r "CI J `J���� i_��--S•f� Ctc CONSTRUCTION INFORMATION: Additional work to be oertormed under t ispermit—check a appy: HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors 11 Electric ❑_Plumbing Sprinklers E]Generator 1:1 Roof / Z Roof pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ n0 Utilities:Sewer O Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name J L\ Name: rl Address: A o � [_d'0e.✓r (:::-t- Company: City: State: Address: it Zip Code: 3Lkq!5 A, Fax: City: Stater Phone No. Zip Code: L::�4R4—'2 Fax: E-Mail: �� Phone No. `-ko I-9" , 1 Qj Fill in fee simple Title Holder on next page( if different E-Mail• r �} from the Owner listed above) State or Coun y License: C If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. 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: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 fi I spection. If you intend to obtain financing, cons with lender or an attorney before commenc' work or recordingour Notice of Commencemen Signatur of O er/ essee/Contractor as Agent for Owner Sl'gnafur4 of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 7% GKC COUNTY OF kAA4Lt1C The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of AeRlJL 20�by this/V day of 6PRi L 20N by G 16.(4�ti IZo &r-g L 19/9 C-a,U Name of person making statement Name of person making statement Personally Known 54:�� OR Produced Identification Personally Known '--� OR Produced Identification Type of Identification Type of Identificat or n Produced Produced (Signatu of t P bl' State of F i a ) (Signat re N ry P ic-State ofpQiida Co s on (Seal) Commission No. IDDE AE"U87 EY apt.... Conir+�itei nAE6 OG11529g • • moo^6©G 113296 w + Expiht Jw*16,2021 AIZgE JWA 1150 am X40 ads rwwaow" REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17