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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED U Date: ti� ti� Permit Number: a RECEIVED M Building Permit Applicati n APR s 7 ^018 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: Wq Yt_r VN PROPOSED INPROVEMENT LOCATION: Address:4W N Y . I Legal Description: n Z Property Tax ID#: K S Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: _ Right Side: Left Side: DETAILED DESCRIPTION OF WORK: CONSTRUCTION INFORMATION: Additional be performed under this permit–check all that appy: _Mechanical as Tank —Gas Piping _Shutters _Windows/Doors _ Electric Plumbing _Sprinklers _Generator _ Roof Pitch Total Sq. Ft of Construction: _ Sq. Ft. of First Floor: Cost of Construction: $ II S:;Pj t 03© Utilities: _Sewer _Septic Building Height: OWN�E"R�/LESSEE: CONTRACTOR: Name W Name: I )f_'nf11cwV Address: MLjpJT��� '7�`Z Co�pRaBy. City: w+ pt-piC-e Stater Address: " Zip Code: 64!" 4'1 Fax: City: State Phone No. Zip Code:, Fax: E-Mail: Phone No 44S c I_�cL l Fill in fee simple Title Holder on next page ( if different E-Mail&COcY C RQ TI)i ,ETV.,40';Df(SL SCM from the Owner listed above) State or County License ( v 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: I 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 subiect 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;ecording your Notice of Commencement. Signature of Owner/Lessee/Contra/or as Agent for Owner Signature of Contractor/License Holder STATE OF FLO!9WaA'- STATE OF FLORCOUNTY OF COUNTY OF ( '( The forgoing instr men was acknowledge before me The forgoing instr nt as acknowledg before me thisday of 20 by thisT day of 200by 67 (Name of person acknowledging) (Name of person acknowledging) ( ignatu a of N ary Public-State of Florida ) (Signature of 'ary/Public-State of Florida ) Personally Known OR Produced Identification Personally Known_ _`OR Produced Identification i Type of Identification YTvpP cf,der,ufication Produced y4 ��;°�% ANTHONYT1LLhUN produced avou ANTHONYTILLMAN t—Commission#GG 180621 Commission#GG 180622 Commission No. TM, �J �'2022 Commission No. W411e � (saoiji January 30,2022 �oMwySw4w OFB0, TtW BuApett10� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIE`dd� DATE r RECEIVED _ DATE COMPLETED Rev. 712014 —