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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLEINFOMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED J �,9 Date: /• 7 Permit Numbe l�[�7— k ED R E r' V Building Permit Application JUL 2 0 2018 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: c� PRQPOSED INPROUEME T LCATIQN: Address: eC4 ' rhEvl`7 Legal Description: Property Tax ID#: — , " 000 1^ O o Lot No. Site Plan Name: Block No. Project Name: �- — . ►• . Setbacks Front_ Back: Right Side: Left Side: DE AI'LED DE=-S`CRiIPT(ON t� �ll/aR�K: nil C (P,350 P . 00 con �n re U r- CDv c a CONS RUCTIO IUR 8MATION: Additional work to be pertormed under this permit—check all that app y:. _Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: 4Sq. Ft. of First Floor: Cost of Construction:$ Utilities: _Sewer _Septic Building Height: 0 SS Name CONTRA OR: Name Name: Address: IlJ rCJQR A Company: City: 1t'1f Ce. State: fq Address: Zip Code: ttFax: City: State: Phone No. D �O—q g ` q Zip Code: Fax: E-Mail: 9-4 V F (&—' M 15 k) COiM 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. SUPPLEMENTAL C©NSTR �CTIQN 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 firsyApspection. If you intend to obtng, consult with lender or an attorney before corrimencingAvcIrk or recording =41ement.our Notice of N �LL� SigZtuf Owner/Lesse ntractor as Agent for Ow � gnature of Contractor/License Holder �Z'265 M� e STFLORID - OSx ATE OF FLORIDA COF Iili� "' LINTY OF Cn Thg ins nt as acknowledg�j efore me " b ' forgoing instrument was acknowledged before me thay of 20/0 by ' day of 20_ by Name of person making statement. Name of person making statement. PA No Personally Known OR Produced Identification Personally Known OR Produced Identification Type of IdentifiType of Identification Produced Produced OL �e 1 (Signature of Nota 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.