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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE I FO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 7 Q Permit Number: VE �a' LJ s r _ Building Permit ApplicaLR JUL 9 2018_ED Planning and Development ServicesBuilding and Code Regulation Division mitting Department2300 Virginia Avenue,Fort Pierce FL 34982 . UCI CO U n ty, F LPhone: (772)462-1553 Fax: (772)462-1578 COOT mercial Re PERMIT APPLICATION FOR: 4f'i5-TN& �- PROPOSED INpROUEMENT LOCATION: Add ress:'f Vq,_ So oaelw 60&L/ D(' Legal Description:, orj 21 AWe L14 �� I 0 • L� C� 1'L y l ao Property Tax ID#: �Ll 0- O a " 0 0$l�- bD©�o� Lot No. Site Plan Name: Block No. Project Name: S 11, l` j e, Setbacks Front Back: Right Side: Left Side: DETAILED DExSCR�IPTION OF WORK: C©NSTR�UCTIO'N INFORMATION: Adaitional work to be performed under this permit-check all that appy: _Mechanical _Gas Tank —Gas Piping —Shutters —Windows/Doors _Electric _Plumbing. _Sprinklers _Generator _Roof Pitch Total Sq. Ft of ConstrucionO f9 • 00 b Sq. Ft. of First Floor: • � Cost of Construction:$tUtilities: —Sewer —Septic Building Height: ME NER/11111USUREE: CONTRACTOR: Name_ - -° Name: Address: -- f��/T l� ate lis . Company: City: ©YlG z° State:RLL Address: Zip Code:- /�i�� Fax: City: State: Phone No. 7/7A- _ Zip Code: Fax: E-Mail:_ "''n" Phone No Fill in fee simple Title Holder n 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. SUP 'CEMENT L CONSTRUCTION Ll,EN LAW NFORMATION: 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 thepermit 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 orMcording 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 OF -S-Y. 1_y e Q COUNTY OF The forgoing instrument was acknowledge before me The forgoing instrument was acknowledged before me thisl a day of w\y 201 by this day of 20_ by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notaryblit-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification _ Personally Known OR Produced Identification Type of Identification _ 1 Type of Identification Produced 'Vt- blr g a�EGNEr1s `�, Produced r,� pc1�P1N�Vill N#GG 02200 Commission No. ��CSu%{. M'����eah),eem�s16 �e,wnler,� Commission No. (Seal) g� r; sae GXP�nNllotz�lPutiicU�� REVIEWS FRONV ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 7/2014