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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:_ Permit Number: 'C VL u Ron RE �. JUNC!! 01 Building Permit Applicapn Planning and Development Services ermitting Departrne ,t Building and Code Regulation Division St. Lucie County, 2300 Virginia Avenue, Fort Pierce FL 34982 -_- Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential ' PERMIT APPLICATION FOR: PROPOSED I�NiPROVEM=ENT-LOGATia Address: Legal Description: Property Tax ID#: . A) 7 V ).- 00 n – 0` Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: 11RA2 I i 111 @ PJ DE8SCRIPTIOINS' 0, WORK: '., CQNSTR,UCTION IiNFORMATION, Ad.ditional wor to a pertormed under this permit-check Oil that appy: Mechanical' _Gas Tank _Gas Pipirig. Shutters Windows/Doors ✓Electric Plumbing _Sprinklers s _Generator _Roof Pitch Total Sq..Ft of Construction:, ,49=0 Sq. Ft.of First Floor: Cost of Construction: $ /, Orae. 6B Utilities: —Sewer _Septic Building Height: OWNER/ E�SSE ; CONTRACT©R: Name k6z,dac,4 le a ti`Z .L-41 C Name: f plc Address: iA Company: OC -ems 'd�&f 4y ;C Ch City: „�y,,,Q f— Stater Address: Zip Code:�R jf 21 y Fax: City: �S- Z- Stater Phone No. 779�– 3,s-9 -o Zip Code: Fax:tL E-Mail: Phone No7 !, - Fill in fee simple Title Holder on next page(if different E-Mail �, �- from the Owner listed above) State or County License zy 0 f If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. S PPLEMfN AL. C®NSTR+UCTION 'LIiEN LAW IN�F®RMATI`ON: 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. gnature of Owner/Le see/Contractor as Agent for O ¢ESN Si nature of Contractor/Li ense HolderLU © STATE OF FLORIDA z a STATE OF FLORID '- M a� COUNTY OF m o OUNTY OF /k Ym55� S SCC 2 W�W The f rggjDg instruct as acknowledged fore me a oX he forgoing instru ent was acknowledg efore me �a this y of Cr,/1 20y �"' m his day of 20by a>-w m :z= (Name of person acknowledgingame of person acknowledging) (Signature of N ry Public-State of Flori a) (Signature of NoV61 Public-State of Florida ) Personal p�Know n OR Produced Identification Personally Kigoown OR Produced Identification Type of Identifi io Type of Identificatro Produced Produced ` Commission (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.