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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / fo& . CJn Date: Og,�Isz a Permit Number: Mai 13MIT22 RE E ED • 3 JUN 1 1 2018 Building Permit Applica ion Planning and Development Services. Permitting Department Building and'Code Regulation Division St. Lucie County, FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential . A PERMIT APPLICATION FOR: e PRORf+3SED IN�F'ROUEMI?NT LOCAT +`N: Address: I vt�,� Av/c o4- 5 Leta 3Y'l F3 Legal Description: Property Tax ID#: 39 19 - 53o - o 2-2-q- ©o 1. Lot No.� Site Plan Name: Block No. �Q Project Name: " " """I "I V Q."- �✓�'� Setbacks Front_ Back: Right Side: Left Side: _ IMAILED DESCRdPTION R MWERRK: �o 4 j7pvlcz --'o kkpw V IrnY F2YnC;L 6/ T / i /' ,rte . T-2PlcA � �,�1� x b I'�d4r�1 1 6 0- R kl 'f Qn Ck CQ STRUCT J, 1'NFOR+MATION: Additional work to be pertormed under this permit-check a 't at apply:.....-,.. _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:$ Z Utilities: —Sewer _Septic Building Height: OWNER/I E-4S9 fE: �NTRAC+�TQR: Name &I ;) QY 2Name: Address: ISI N 94 V f- Company: City: Fc S� . Lt"1 State: Address: Zip Code: Fax: City: State: Phone No. 305- 40q 1 Zip Code: Fax: E-Mail: 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. SUPPLEMENT1aL CQNSTR CTI©N LIEN 11 M. 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 ace with thea roved plans,the Florida Building Codes and St. Lucie Count Amendments. PP P g Y 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 wo[LQr recording our Notice of Commencement. Signatu wner/Lessee/Contractor as Agent for _ Signature of Contractor/License Holder STATE OF FLORID �° '" STATE OF FLORIDA COUNTY OF COUNTY OF �X�g The forgoing ins m t was acknowledge efore m z m�9 The forgoing instrument was acknowledged before me this day of 2016-by � this day of 20_ by TJ C�T Name of person making statement. ^ oA Name of person making statement. Personally Knowe—, OR Produced Identification ersonally Known OR Produced Identification Type of Identificatio Type of Identification Produced �C, Produced (Signature of Notfjy Public-State of Florida ) (Signature of Notary Public-State of Florida) 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.8/2/17