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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:' . 1 - 112 Permit Number: (,IJ 13- , RECEIVED - -- Building Permit Application Planning and Development Services MAY 0 7 2018 Building and Code Regulation Division ST. Lu ounty, 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 1 PROPOSED IMPROVEMENT LOCATION: Address: iZ (OS r'[C� L.<-^<-,f icn- L.<-^<-, �Q vi,% G:�"'L EL 3`4` g o Legal Description: 4v—"&r r V i kkaI le Aarl oar " CSL pl" � y�1'T ( � ar X117 - 2311 Property Tax ID#: Li4 UO SS - 000 ' Lot No. Site Plan Name: Block No. Project Name: rulr-a n Pe.Ao Setbacks Front Back:_� Right Side;/V_4 Left Side: DETAILED DESCRIPTION OF WORK: �Zw 1w-�:�:u� � Y'G rwrc. �,G (c,�r►+�_S, cf-r% W1Gcwwk� ,vs P CONSTRUCTION INFORMATION: Additional work to be performed under this permit-check all apply: HVAC Gas Tank []Gas Piping _Shutters Q Windows/Doors Electric Plumbing Sprinklers 0 Generator L]Roof Roof pitch Total Sq. Ft of Construction: S Ft. of First Floor: Cost of Construction: $ Utilities: Sewer E]Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Gr Name: Lrm Address: 21or- &VId V r tr" Company: 644V C=nS I��,Y4j�ov- AA City: CA ; State:fL 3 � /iii Address: 1. 3 5 6"y-u AV L_ Zip Code: Fax: N/11 City: �}. wt�_ State: l_ Phone No. _]'2 2' 33c.- 23o5Zip Code: 3q,714 Fax: -77Z-7$l— 8$0 E-Mail: Mg rL 2k to P, Ln^r- ) �^ .tl1L� Phone No. '772.- M-- Flo Fill in fee simple Title Holder on next page(if different E-Mail: q�1GS��N+ici�r:: © 661 g¢w%• re from the Owner listed above) State or County License: C&i 04ot 313 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. i SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: Ir State: Zip: P one Zip: P o FEE SIMPLE TI E OLD R: Not Applicable BONDING COMA /_I_-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 andpost d on the jobsite before the first inspection. If you intend to obtain financing, sult with der or n at rney efore commencingwork or recordingour Notice of Commencement. • ;1�\ V�v Signature of Own?f/Lessee C ntractor as Agent for Owner Sig ratu re'd Co ractor/License Holder STATE OF FLORID ~ E. STATE OF FLORID COUNTY OF IIJLr✓'{ Z/ COUNTY OF Th g instru en as c nowledg�efore me The f�stru ent a o ledge�J ore me t y of �� 20 by this day of n �20 1 y Lkk'o C'� Name ofn making statem Nam p s n making statement Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identif' tion �1 f Ide i �� d = c Produced LJ Prod 11 CJ '(SQ' re of Notary Public-State of Florida ) (S' natu a q�dc iry PubA j�gkp bl Florida ) °"►SyPoa�, JENNIFER CO * * Commission#GG 15619 CoSON sion No Commissi 2(Seal) * C'v_' omm ssion#GG 156192 ry;— °o Bonded 6er 30,2021 �m Expires October 30,2021 AdgelNo�ryservkea TF REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17