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HomeMy WebLinkAboutbuilding permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Li Permit Number: 111.11- _11111111 Jill . 1111111 11 1 MW wilding Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fart Pierce FL 34982 Phone: (772)462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: pROPOSFD INPROUEMEIVT LOCATICsN � , :' :._, HAa Add ress �J 5 �J �l1 ��11 v r - Legal Description: Property Tax ID#: 1 31 Q 503 ' COS-] - a®© Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: 5 is DETAILED? DESCRIPTION OF WORK. x - _".a k 3 fi . C�p�q} (w,+Iy' p !!vv [/+,( +y�1 [/�� it P R_' -� £: ' d 1-a�d P B.E')...d' iU�sT)ON IIF*✓Irtl1ATI V.N. 4J..� � `Y`.�j �j" �"ykl'L A ditiona k tobe e rmed uhis permit check alFtl at app y: 1/ i&chanical Gas 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: $.L� i ,;LOO 00 - Utilities: Sewer _Septic Building Height: gl ur.mCz1111NER�LESSEE h � QNTRACTQRI t�k . ".. . ... N7 Name 4 Off1 02 Name: ,}� Address:l5�5t.p �f7© I"<Z l I Vey Company: +� t �tTy City: fii State: Address: Q CId�Qf�L& Zip Code: b!� 1 Fax: City:,'eof---� vkffce State:_ Phone No.LP L, (P- �j 0 Zip Code:. Fax: _J1)-- �'J--59 g E Mail: { LDS-1 Q LArkno C O Phone No 3q- ( )HC,, Fill in fee simple Title Holder on next page ( if different E-Mail C �a �ti(Cl Q Il'-1CLl � . C�t�`� i� from the Owner listed above) State or County License 7 If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. 'P' �IALaNSfiaOCTIOW.,LIEN LAW INFQRIVIATIQN 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 first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. C Signature gVOwner/Lessee/gntJctor as Agent for Owner { Signature of ontractor/Lice s Ho er STATE OF FLO DA STATE OF FLORIDA COUNTY OF oc t-_ COUNTY OF 15�, C' The forgoing'nstru ent was acknowledged before me The fora�,.$_in�g instrument was acknowledged before me thi `day of r " I 20 1 by thi 9 flay of 1�r, 20 I'S by (Name of erson acknowle ing} i (Name of pa/son acknowled } (Signature ol Notary Public-State of Florida J (Signature of N tart'Public-State of Florida ) Personally Known OR Produced Identificatkon _ Personally Known OR Produced Identification Type of Identification Type of Identificatio.� Produced t _ �. Produced J� �._STATE Stephanie cure rr oNOTARY P IG � I { S"EW hi MCommission No. I'IE 9-)-) 3-6 � � fission No. �OF i LO[xnrr►#FF 7381 xpiresREVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURLtr COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW r DATE RECEIVED DATE COMPLETED Rev. 7/2014