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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 5"NG Permit Number: N'3 S-6 L1(O co ,,,_�� -- RECEIVED • Qiir�wr Building Permit Application MAY 16 2018 Planning and Development Services Building and Code Regulation Division ST. Lucie County, PlrRtlttlnp 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�a,rq dd PROPOSED IML OVEMENT l N: ' Address: >, ., j'l ll�DEQ Kl�l C�� /� �d'.�l�l l�� 3 q Iff3 Legal Description: HI DI�C� V CSTA'r /JLL S N (OK `3-7 8'9 -K1) Property Tax ID#: -31 3LJ — 701 — COX& 000 © Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: l�l%I►�liL L � 1 11)L'L--i (;7i1i-moL �AD�- . .}NSTrt cL, tit; �• �nrj Cju lCq�uL /►1ASrEl� )MODEL gaq 57vl�- - 5--R-w miu c) i It>q Cu-S App HA-R l oAk CONSTRUCTION INFORMATION: Additional work to be oertormed under this permit-c ec a appy: HVAC Gas Tank Gas Piping Shutters1z Windows/Doors ❑Electric ❑ Plumbing Sprinklers ❑Generator F]'Roof Roof pitch Total Sq. Ft of Construction: S Ft.of First Floor: Cost of Construction:$ 5 Utilities: _Sewer E]Septic Building Height: OWNER/LESSEE, Name ] KmsG K--IL Name: >= A AI V PRAL�' Address: Q 05 S, et DDSWP, Company:D- C hvD MDQ DF- TqeT.c City: -hist I (,aCI1; State: t'�— Address: 932 .S( zW 5 WW Zip Code: :5LM f 3 Fax: City: :—::CC.� State:__rL Phone No. 1 a' 3 LJ )- " kJ U t Zip Code: 3` q LfS_ Fax:`P 1�� u " /� 3 E-Mail: Phone No. 7 a' Fill in fee simple Title Holder on next page(if different E-Mail: &4100 1 V, CO Al from the Owner listed above) State or County License: Cil/' j 15 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. �... VON 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 commencinp,work or recording o Notice of Commencement. A �b&44 od, 1W 6AAA Signature Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLQRII)A STATE OF FLORIDA COUNTY OF • �-uc COUNTY OF -!&k • L V cry The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this LCp day of 20�'t by this\S day of 20�i by 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 L 0 L Produced L- C) L, (Signature of Notary - o �It�d�;RIEGNE2' (Signature of Notary P blit-State of Florida ) MY COMMISSION#GG 022029 3r Commission No. � �5� � l XPIRf mfr 16.2020. Commission _d Thru Notary Pubiic UndFwn!3 NAM I MY COMMISSION#G22023 ' +? EXPIRES:December 16,2010 Bo ed Thru Nc?ar' .c erwMem _ REVIEWS FRONT ZONING SUPERVISOR PLANS V T ., ROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17