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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: f , p' Permit Number:KECE OEM ffift �a Building Permit Appliction APR 1 8 2018 Planning and Development Services Building and Code Regulation Division Permitting Department 2300 Virginia Avenue, Fort Pierce FL 34982 St. LUC - U nty, FL Phone: (772)462-1553 Fax: (772)462-1578 Commercial R PERMIT APPLICATION FOR: PROPOSED {NPROUEPUI`EN1` LOCATI`ap'N: 10 MEN iiiiiiiiii;I Address: Z v �f !/'(S�A T Vl.�r� ���✓`�h�+c�a� ( /®L Legal Description: -e C7 G-A 11(3 I✓/ dYWC_ Property Tax ID#: - s0- � Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DET II_ED DE-�SCRI�PTION OF `OR4K: CONSTRUCTfON INF©RM TION: Additional wor to a per ormed under this permit-c ec a tat appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric45 lumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Constructions: Sq. Ft. of First Floor: Cost of Construction: $ Utilities: -Sewer —Septic Building Height: OV!/NER/LESSEE: CONTRACT®R; Name DP)V�lib h io Name: o V^^- Address: 2`1 �A��ti U Company: /4,A i,^ Ig l(J 1' C City:_G V4- o c-V`�" State:e� Address: / 7 7-J- Sf--' c l.,, Zip Code: '�Y5-5-Z- Fax: City: Stater Phone No. 2f Y 1 0 C I I-y Zip Code: Fax: E-Mail: Phone No ��� <J� Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SE�IPLEMENTAL CaNSTRUCTE®N LEEN LAW INFORMATEQN: 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 oft is requested permit, I do hereby agree that I will, in all respects,perform the work in accordance with the app ved ans,the F , ida Building Codes and St. Lucie County Amendments The following building p mit plic on re exempt from undergoing a full concurrency revie oom a itions, accessory structures,s in g p s, nces,walls,signs,screen rooms and accessory uses t nother on-residential use WARNING TO O N . Y f ure to Record a Notice of Commencement ma r suit' yo ing twice for improvements y p y. A Notice of Commencement must be rec ed d os d on the jobsite before the firs ns ct' ou intend to • ncing, consult wit nd o n torney before commencingor or o -ice f Co encement. rz� . N Signatur of Own /Lessee/Contractor as Agent f 6v-ar� SignaturVFFLOR o act r/License Holder a LL m w�c�u� STATE OF FLORID ooa STAT ID Y COUNTY OF ¢rUj:1 COUNTY OF a The f r ping inst.TAipent was acknowledged before a:*'.'agao, The f , ing instr nt wa§.acknowledge �fo rr� this day of �I 20 y Py" this/ day of 20�(� by (Name of person acknowledging) (Name of person acknowledging) (Signature of N ary Public-State of F orid ) (Signature of No Public-State of Florida) Personally KnownOR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Iden ti n Produced 'C-1 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 Rev.