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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / � Date: lS�' ' Permit Number: �� O iG • CjI to V R 5&"C E0 T eaVED Building Permit Ap plicati6p X72018 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 PERMIT APPLICATION FOR: 210W 107E10fNPROUEMENT LOCATIQN: Address: 421X T Legal Description: Property Tax I D#:T 0 '` 6y� �> `- Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DRWIYRD DE-SCR+I°PT 000@,' WOR+K: lJ 0, V-\D_ -Q Q 1Nt U Lf L7 r�c r Irl J T acv. C_rE _ LAJ C'0&1 , 1 S AHC C@NSITI={O tNF®'R+11/IATI©N: Additional work to be pertormed under 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: 0 S Fi Sq. Ft. of First Floor:. Cost of Construction:$ a Utilities: —Sewer _Septic Building Height: OW SER/LE-�StiSE: s CONl"RACT©R: Name IL Name: Address: ! Z/ Co r- a, .1 S' Company: City: P State:8--`' Address: Zip Code: Fax: City: State: Phone No. 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. Sl1"PPLEMENT" L C*QNST'"OT CTIONI Ll=EN LAIN INFORMATION: 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 Ce9ordi_Qg your Notice of Commencement. Signature of Owner Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA - STATE OF FLORIDA COUNTY OFV/,, -COUNTY OF The f r oing instr t was acknowledged before me The forgoing instrument was acknowledged before me this day of 20by this day of 20_ by (Name of person acknowledging) (Name of person acknowledging) (Signature of Vary Public-State of Florida ) V (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identificati Type of Identification Produced A f Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 7/21014