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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUSTCOMPLETED FOR APPLICATION TO BE ACCEPTED S , I J Date: /' �"/� � � Permit Numb 0 :nom j� w RECED- 1 JUL 19 2018 Building Permit Application Planning and Development Services Permitting Department Building and Code Regulation Division St. Lucie Cry ,nty, FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: PROPOSED1NP-ROUEM ANT L®CATiaN: Address: Legal Description: Property Tax ID#: 3 L/ Ll ��® — 1 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILEDD;NMI R1PAT]10N OF VI/ORK: CONSTRUCTION I'NFORMA IO'N: NMI Additional work to be pertormed under tis p—&Fnift 1:.check all that appy: _Mechanical _Gas TankGas Piping CkShutters =Windows/Doors _Electric _Plumbing _Sprinklers Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ �"� ��• d Utilities: —Sewer Septic Building Height: OUVNER/LESSEE: CpNTRA*± OR: Name �m t, � Name: � �,- Address: � 11Q �y'^� ra -av� Company: City: � , l(� �_ State:"%_ Address: 5 0- Zip Code: ' 51k Fax: City:& ,S ..L State: Phone No. Q11 3 Zip Code: � n� ' 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 2,500 or more,a RECORDED Notice of Commencement is required. SUF'PLEM€NTAL CONSTRat1CTl©N LIEN LAW I�NFURMATIORI: 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'restrictor 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 jit before the first inspection. If you intend to obtain financing, consult with lender or an attorney beforrilicom cin work or recordin our Notice of Commencement. := S�'�"µ!'Vi'- M5 /Signre of Owner/Le ntractor as.Agent fo 9!i£ `' :iZgnontractor/Lic s ol. er U E OF FLORI X�g FLORID COUNTY OF __oOUNTY OFm�The for ing instr t was acknowledged befor d g= The for oing ins T nt was acknowledge forthis day of �t 20by �T this day o 20y _ T72 a ^�' m r�i � r�� /r (Name of person acknowledging) (Name of person acknowledging) (Signature of Nota ublic-State of Florida) (Signature of Notary P b c=State of Florida) Personally Known_ /1" OR Produced Identification Personally Know OR Produced Identification Type of Identification Type of Identification Produced 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. 7/2014