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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED i Date: q_. Ito• `s Permit Number: - RECEIVED Building Permit Application APR 2 6 2018 Planning and Development Services Building and Code Regulation Division ST. Lucie County, Permitting 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 Ce PROPOSED IMPROVEMENT LOCATION: 1 Address: 93/(D Scu. h O'at'O -) it Jenst' l &ac '1 'I Legal Description: h t0um O n d.- ,.5 n d- 12(CA]0�2 Ln f 4.1, — Property Tax ID#: 9 5,3 /'Sb — O© +3—000 —� Lot No. Site Plan Name: 5h'I a n Block No. Project Name: k i n n Setbacks Front l a5, Back: i D 1 Right Side: in Left Side: DETAILED DESCRIPTION OF WORK: I J hipcit n ►���u� � 5fu W, &1-., Singh e 904e,5 Ce- An F-aY LIr P r o�� (\,.�� -� 114)15, CONSTRUCTION INFORMATION: i itiona wor to e er orme under t ispermit—check all appy: HVAC Gas Tank E]Gas Piping _Shutters Windows/Doors Electric ❑ Plumbing Sprinklers ❑Generator �Roof Roof pitch E Total Sq. Ft of Construction: SFt.of First Floor: j r Cost of Construction:$ 4 f0(7t7 Utilities: _Sewer E]Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name_1 n-) iCA. iL-C�- . �1 1 Name: C 1e5}��' �C�YYI e—ItiCI. Address:_'re17 i✓001 KQQp� Su�tC ppb Company: S{ � &M,(JQ1'yy City:�rCL✓►,C i; Dcr`t FyiCL V-1. �. State:��W Address: _PO bOV-, JJo J(,o Zip Code: 0 7D to-7 Fax: City: `swL�A4 State: FL Phone No. (P It-'X3,2-- (ayinc ii y- Zip Code: a4c?' 5 Fax:1)1a �d88-3D35 e E-Mail: Phone No. -''72' a V9— 105 Fill in fee simple Title Holder on next page( if different E-Mail• A'L .1 L-1"i:"cf— On CaSpt(�h. ►'1� _ from the Owner listed above) State or County License: cRO"?77 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: 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: I 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 commencin or recording our Notice of Commencement. Si atu of Owner/Lessee/Contr ctor as Agent for Owner Sign Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF L)ql COUNTY OF �aW A The for Ing instrument was acknowledged before me The for&ging instrument was acknowledged before me this Qi�.day of 20a by this�r�9ay of m( AC9,b 20j'9 by cn4c t c"ft fYi&-YL.G 0'-�l e'5 L ct)M o—KG1L., Name of person making statement Name of person making statement �) Personally Known ✓ OR Produced Identification Personally Known ✓/ OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary Pu (Sig ature of Notary Public-State of Florida ) ri. DIANE K BONDDIA&F�K BOND Commission No. MYI�IISSION #FF185430 Commission No. '?� °` F.XPIRS December 28,2018 ,w MY COMMISSION#FF185430 407) h 0163 Fioridallota SOrvIC('.00M ,;. PifiES December 28,2018 nrvir,e:�tlrn REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE - RECEIVED DATE COMPLETED i Rev.8/2/17