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HomeMy WebLinkAboutBuilding Permit Application i All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: r 'V RECEIVED Building Permit Applicatio JUL 12 2018 o Planning and Development Services ST. Lucie County, Permitkin_: Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982. / Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: 11 \VA�®w .b© �C_ R®'POSED LN!PR©VEMiENT LOCATIQN: Address: Legal Description: d� ��a����l�o ' ono Property Tax ID#: Lot No. Site Plan Name: Block No. Project Name: f ��C'�u/-� �' 0cxnrs Setbacks Front Back: Right Side: Left Side: DETAILED DE�SC•RIP12 TI©N OF WORK: ' v C{?NSTRUCTION 1NFOR+ ANION: Aadilional work to be performed under this permit_–_c_fi_e__cR all that 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: $ L7. ��. Utilities: —Sewer —Septic Building Height: OWN ER/LESSEE: CONTRACTOR: 111111 NameZ Name: Address: U .ae Company: City: State:L�G _ Address: Zip Code: RS�J Fax: City. State: Phone No. Zip Code: Fax: E-Mail: �i� no'�4�, fi�'�c,v 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. SUPPLEMENTrAL CONSTRUCTION LIEN I.A163IN'FORMATIQN: DESIGNER/ENGINEER: --j- of Applicable MORTGAGE COMPANY: _ of Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: of Applicable BONDING COMPANY: of 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. i ature of Owner/Less ee/Contrac or as Agent for.Owner Signature of Contractor/License Holder STATE OF FLORIDA L p STATE OF FLORIDA COUNTY OF 4. Luu C. COUNTY OF The forgoing instr meqt was acknowledgeg before me The forgoing instrument was acknowledged before me this C1 day of 20by this day of 20_ by Name of person making statement. 1 / Name of person making statement. Personally Known OR Produced Identification V Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary Pu lic-State of Florida) ignature of Notary Public-'State of Florida) Commission No. �,�PYp•,,, IyEN S. NIELSE S a e f Florida-Notary Pu ii mission No. (Seal) _. •_ Commission'# GG 2b7484 =� ornm;ssion Expire June 1 ��n nay REVIEWS FRONT -TU --5U-PEKV1S*3U6R PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.