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HomeMy WebLinkAboutBuilding Permit Application y All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:��(`1T� Permit Number: I O U 2b - � - ECEIVED Building Permit Applicatrent:ia Planning and Development Services U L 3 0 2018 Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 ie County, Permitting Phone: (772)462-1553 Fax: (772)462-1578 Commercial Resi PERMIT APPLICATION FOR: ROPosEo N�aRov�MEIVT�:ocA aN: Address: J Legal Description: Aft S Property Tax ID#: J L l]�• 01. 0 UU,i 0000 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: _ DETAILED DfSCRI'PTIO aF WORK: co, 7L 302 s-OO c lb ER— ;marc h CONSTRUCTION 1NF©RMATIO Additional 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 Construction: Sq. Ft. of. First Floor: Cost of Construction:$ ( Utilities: —Sewer _Septic Building Height: 01 tiNNER/LE�S� EE: CONTRACTt?R: NameL— k� c�i /lQ �2x Name:.;- Address: e �a Gy V4 0 Company: � City: �j4,fLc--7� State: Address: 1" ` Zip Code:_–!�4(2tdb Fax: City: _ State: Phone No. 6-7-762 cU 4 —I g71r, Zip Code: Fax: E-Mail: /'/QM n2 03 Q ! /jz Q.'Coo-1 Phone No Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License lEvalue of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMEN Al.CONSTRUCTI©N LIEN LAW UNFORMATlON: 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 covenahts 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. U Signature of Owner/Lessee/Contractor as nt for Owner Signature of Contractor/License Holder STATE OF FLORIDA, STATE OF FLORIDA COUNTY OF COUNTY OF The f oing instr m nt was acknowledg before me The forgoing instrument was acknowledged before me this day of 20LA by this day of 20_ by t -)L�Intk . 1B1.1n .1r. Name of person making statement. / Name of person making statement. Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced jA (Signature of Notary Public-'State of Florida) (Signature of Notary Public-State of Florida) Commission No. AREN(�eaRIELSEN Commission No. (Seal) ;=o` B<<-;State of Florida otary Public -, Commission # GG 207484 "�9l P$ June 12, 2022 REVIEWS R PLANS VEGETATION SEA TURTLE MANGROVE C UNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 8/2/17