HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: b y ly'\�
( 37
RECEIVED
Building Permit Applicatio 1 APR 16 2018
Planning and Development Services ST. Lucio gomnty, 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:
PRC7POSED IMPROVEMENT LOCATION.
n ,
Addriess �r��d G(✓S /4'- U ? �a� h ' S
,
Legal Description:
Property
SO : /'le_7 0O l)—S Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTIMOF WORK
c cl r,+ Appfuc L, FL193
rCON ' RUCTION INFORMATIaN
Additionalwork tobe per orme un er t is permit—check f all that appy:
_Mechanical _Gas Tank —Gas Piping _ShuttersWindows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ yZlZ Utilities: Sewer _Septic Building Height:
ODUNERJLESSE CONTRACTOR: z
. .,
IN
ame ,..Z,,�G61' r4 144,7,e2Name
ty ddress: -I `,G��(/�G'GL,S . �12 Company:
City: S L State: i=L Address:
i ip Code: -3 f Z_ Fax: City: State:
hone No. 7 7 — 7 7 ✓_ Zip Code: Fax:
E Mail: / :Phone No
-I I in fee simple Title Holder on next page(if different -'E-Mail
f I the Owner listed above) State or County License
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRiUCTION LIEN LAIN INEQRNIATIQ`N a
DESIGNER/ENGINEER:, ER ,.
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 first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Signature Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF G5112- 1,c/L,rt COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this is day of li Ci L 2011 by this day of 20_ by
(Name of person acknowledging) (Name of person acknowledging)
( ignature of Notary Publ' State of Florida) (Signature of Notary-Public-State of Florida)
Personally Known OR Produced Ident nnPersonally Known OR Produced Identification
Type of Identification Type of Identification
Produced
Produced �l C ( ) Commission No. (Seal)
Commission No. Seal
=u NaCD
REVIEWS FRONT ZONING �f4Y1 PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE ,
COMPLETED
Te—v. 7/2014