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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: \' o! 1 (� Permit Number: \ U l O RECEIVED r Building Permit Application Planning and Development Services JUL 2 7 2018 Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 ST, Lucie Gp�+n' rmitting Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of lin � ��,• r � a *ter<,,� ���� �} � ��. � � � s � � ��� z -OR Iooso�IllRrEII�To �� � 4 b � � � � }3 Address: Le al Description:_ AAT 3 J 5QJVL ArD j�A_ieflE�s `p, q� opLOt" aD +Li- i br 1I Lo•2-9 (Q/Z 1'73 Property Tax ID#: d 5 ©�" 9��aZ` ��� '9 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: €� «r�fxj �ya �`�S rsl'* . �y(q{� �, y a,�,♦♦ a ��.'�� ��� -� , _ �,G,_. d> _ �0 '"� 9ZWVi- PrVn W#uz A*MfY 4A•, t-- bo,90L. �rv�MU Ne"k) l ro'X 7 ' b A6 `neY/.s-tpisl4 HitegAeAN9, JOA-f7-67L T- 77— ", � .��"r ?gs��-.�� e''�j ��. ,€ Z,�� :rr 1!�!�';(/��{� a+ ��.+`�}!z�� �}{��� k�' `t.. t �>�YY'• T./� �'i M/R•[,.AT��N M P"��t'�y y 3�3� L i.*� +W� .�4-• Www... ...,n'.'t or to e e orme un er t is permit-c ec a appy:Gas Tank ❑Gas Piping Shutters Windows/Doors ic 0 Plumbing Sprinklers 11 Generator _Roof Roof pitch Total Sq. Ft of Construction: 2 S Ft.of First Floor: Cost of Construction:$_ 1 3� ,�� Utilities:cn Sewer 0 Septic Building Height: .`riffl € _ Name Name: AD6_ 00 "t Address: p��W AV&: Vu� �Cr Company: a4s �D bV x r rip- ��- City: F+' �lmec- State: L Address: '3-? S• ! -tV Zip Code: 3IL I Fax: City: Pi-, Pd�E State: L Phone No. Jr(8�- a� -�S Zip Code: ZYJ Lk ✓ Fax: �3 E-Mail: Phone No. ��� o Sp I Fill in fee simple Title Holder on next page(if different E-Mail: � nn� Dl� �� CB from the Owner listed above) State or County License: C RX_ 13 3 l SYd If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. IN a. ,�s�,� DESIGNER/ENGINEER: _Not Applicable 1.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 recordin ur Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDASTATE OF FLORIDA r . ,C `E, COUNTY OF ,1r, COUNTY OF 1U The forgoing instrument was acknowledge before me The forgoing instru ent was acknowledge efore me thi �day of �? 20a_ by this day of 20by Name of person making statement / Name of person making statement / Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification Type of Identific ' n Type of Identific n Produced ( �� Produced (Signature of Notary Public-State of Florida (Signature of Notary Public tA OZPRY pLe/� j Commission 4��`�,YP��, KItatAREN S. Nb y EN � StaKARCN 5 NlEN 3s ns Stat.Of Florida-N Public Commission No. 9 oP: G0t ��orida-Notary Pubic • Comrnission S GG 207484 '',�oFF�oP:� ��� mission#GG %�+ a My Commission Expires ��'"""�� ,,/Chine��ion Expires REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17