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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number. r rs�5.. .•. IC .r .�ii • RECEIVED Building Permit Applicati n Planning and Development Services MAY 1 2��$ 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: � UJ r Address: Legal Description: 1�PS1 c�1 h wlrngU`�' I�l' 0A C n �- Property Tax ID#: Ly 0 lug" ©©o • Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAIL b b SCRIPTIONCOF Wb AM h _ 0 W 01& h wi Vi \ fMG w1A&w� ImP�C� C �, r%lu�ic�a �rOc�ic.� ljPPlb Additional work to be pertormed under this permit-check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters UL Windows/Doors _Electric _ Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ 3, � ► ���p Utilities: —Sewer —Septic Building Height: Name Name: Address: 0 1 VI-C Company: City: P.,(J Cl'erc State: Address: Zip Code: 3�-t4r/ Fax: City: State: Phone No. Zip Code: Fax: E-Mail: ``�SC(� � `� ,(UM Phone No Fill in fee simple Title Holder on next page( if different E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. 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 commenciN wo or recording ur Notice of Commencement. Signature#Owner/Less a/Co tractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA ISTATE OF FLORIDA COUNTY OF L• uaiC, COUNTY OF The forgoing instrument was acknowledge efore me The forgoing instrument was acknowledged before me this-W-day of YY1�y 20nby this day of 20_ by 11(��. Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identication Type of Identification Produced r Produced AA (Signature of Notary Pu Iic-State of Florida ture of Notary Public-State of Florida ) iParP� REN S. NIE Commission No. 'o ���6� of Florida-Notaission No. (Seal) Commission #GG 20174844 %y�F oat' My Commission E une REVIEWS FRONT SUPERVIInTr NS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.