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HomeMy WebLinkAboutBuilding Permit Application I All APPLICA LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number:vAl " . . Kan Building Permit Application JUN 06 2018 Planning and Development Services Building and Code Regulation Division Permitting ®epartmen 2300 Virginia Avenue, Fort Pierce FL 34982t, L e County, FL Phone: (772)462-1553 Fax: (772)462-1578 Commercial . Resi PERMIT APPLICATION FOR: PROP©SED IN%R@%Y ENT LOCATION: Address: 3eoj` Legal Description: kc) Al Z 20 DE0 L Z - Ft G F Z O O'�_ SI-1 Of AfL't I/K (6 ,6'3 Property Tax ID#:?Wo -7 - Z3 I " GC)o 2^ Afo Lot No. Site Plan Name: >1A,IIFe --- F=e-ar 4- Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED D'EaSCRIPTION OF WORK: To� Lew, fie 410,l 0-\ fed-c'-^c�Jer� w co J 67 - C& k- ------------- Add.itiona. 1 work to be pertormed under this permit-c ec ,a -t at 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:$ "Z300 Utilities: Sewer —Septic Building Height: RROM"0 11_@'8 S. CONTRA@TQR: Name CVPJ_rs� Name: tel���.• s- Address: TUU O-rctnge_ A._r _ Company: (� ? hc;r ►r�c��� r LC C City: State: Address:_ L-( L")efr- %.lcr'ck or_ Zip Code:'Si-o/ -f 7 Fax: City: Pi- . P"erc C__ State:rL Phone No. ' o 6(, Zip Code: 3q-i"6 Fax: E-Mail: Phone No '1?2- 321-7 5'2- Fill 2Fill in fee simple Title Holder on next page( if different E-Mail 66SA-ear-Cc✓1ce. from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. E; IF C®.NSTf�.tJCTf©N LEEN LAW IaNFORn/l%201'�N: 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 jobs_ite 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. �;. A. Sig ture of Owner/Lessee/C ntractor as Agent f Signature of C ntra cense Holder �;� *; ; Illl„ STATE OF FLORID g STATE OF FLORI COUNTY OF o rn� COUNTY OF / �o'c .o o a ��9 The forgoing Inst m was acknowledged before f� The fo going inst t was acknowledged before me My P3 this day of 20 I by w g this day o 20,1&by z= ' I V� (Name of person acknowledging) (Name of person acknowledging) h dw�� aiLr"�Plkulllx_ V (Signature of N t ry Public-State of Florida ) (Signature of Notes Public-State of Florida ) Personally Know OR Produced Identification Personally Kn n f �� OR Produced Identification Type of Identification Type of Identificatio 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 Te—v–. 7/2014