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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ]� c Date: J� J Permit Number:, s: a aspen xr �� , . low RECEI Cu Building Permit Application MAY 21 2018 Planning.and Development Services Building and Code Regulation Division Permitting Department 2300 Virginia Avenue,Fort Pierce FL 34982 ( �1 c� Phone: (772)462-1553 Fax: (772)462-1578 Commercial esj�}}Lnt12 a Llnty,, FL PERMIT APPLICATION FOR: PR®POS€D INRROUEMENIT INKS Address: 75 7 S L 1 3 Legal Description: Property Tax ID#: "OW 9 ^ / -��.� Or © Lot No. Site Plan Name: Block No. Project q Name: 0YV1�. ��•�G V2�'� Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION ©F WfJR+K; ch CONSTRUCTIaN INF®RMT,ATION: Additional w--o-rlFto be pe orme -un er this permit-check all-that appy: "Mechanical _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: / 00 "r Utilities: Sewer Se tic Building Height: 9� $ �S — _ p g g OW ERjLE=�S�SEE: CONTRACTOR; Name c-)- , Name: -t _C'.UA2 Address: 75 Company: 1S City: Q6!� ,v\r.e' State: r`IG Address: k1Zip Code:Code: .34 0LS";L Fax: City: Q - t c s eS,�C State:�0. Phone No. `]7oL (o�(z t9'1(o2 Zip Code: 11,14 Fax: E-Mail:�� ddl�cs�^ Oen Phone No 1 Fill in fee simple Title Holder on next page(if different E-Mail- 1 Ny-% C from the Owner listed above) State or County License C j'jQ-1 `S3 R a-0 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SCJPPLE�lIElUl' ►LC®NSTR'"TI�N MENLAUtI IN RMATI(•J: }. DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name Address: — - 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 bFhcl orded and posted on the jobsite before the fir. inspection. If you intend to obtain financing, consult en or anattorney before commencin work gp+e4l;ording your Notice of Commencement. •,NAr�- Sig ature of Owner/Lessee/Contractor as Agent fo Sig ature of Contractor/License Holder STATE OF FLORIDA XK STATE OF FLORIDA m� COUNTY OF 9 -moo o COUNTY OF x� F Mgt m z mg m The forgoing instrument was acknowledgedfore w Z The forgoing instrument was acknowledgedef t this day of n r L r 20by �T thi day of 20_ by Z= n NT 9 �T S / ^ � A { fON d �� ke! ,L)71 PW ` Grub Uri • �N I/ (Name of person acknowledging) (Name of person acknowledging) (Signature of No r Public-State of Florida ) (Signature of N ary Public-State of Florida) Personally Known _ _� OR Produced Identification Personally Known,--' OR Produced Identification Type of Identification Type of Identification Produced Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 4