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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 Date: D ' ` 0 Permit Number: RECEIVED- ] Building Permit Application AUG o 1 ?0313 Planning and Development Services ST, Lucie 6oun -, Permits^o Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 -6 Phone: (772)462-1553 Fax: (772)462-1578: Commercial Residential PERMIT APPLICATION FOR: e,� � PROPOSED INP -�OVEME T LOCAT)QN: Address: S�-5 9 y C�t-s4 i.ems Legal Description: Property Tax I D#: ' S C (D ©� 7 f / Lot No. S Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION �'F WORK: C® �TRUCTIQN 1NFC1R� ATION: Additional work to be pertormed under this permit—check all that appy: _Mechanical _;Gas Tank _Gas Piping _Shutters =Windows/Doors Electric dumbing —Sprinklers., _Generator _Roof Pitch Total'Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ ��.r Utilities: _Sewer —Septic Building Height: 0 E�Rf1E�S�E CONTRA QR: Na m 0irl� e'�� 5' Name:. Vb6.,Pv� _ �✓v'�{J_ �C E''g rC�t�. CVL 1 Company: Address: City: �i�( O State:04 Address: .C'72`T S(:.�.. :. ?e!%'+,i:k, � °.,L.'til Zip bode:l 2 2— Fax: City: pS L State. Phone No. Zip Code: 3`E�j B �� Fax:_. E-Mail: Phone No '_7 72 37� llS Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License R- HDOEIS If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL O 19,N'STRUCTININ LIEN LAWI'NFO'RMATION: 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 app ications are exempt from undergoing a full concurrency review: room additions, accessory structures, wimmin ools,fences,walls,signs,screen rooms and accessory uses toanother non-residential use WARNING T OWNER: our failure to Record a Notice of Commencement may a wl i our paying twice for improvers nts�to you roperty. N tice of Commencement must be reco/rde posted on the jobsite before tFFyy�fi�s�Inspection. If you u end to obtain financing, consult with�end r or an at or before commer>'cin wo r r cordin ur Notice of Commencement. r, r ture f Owner/Lessee/Co tractor as Agent for Owner Signature of ntractor 'cense Holder TE OF FLORIDA Lair, STATE O FLORIDA COUNTY OF . COLIN OF The forgoing instr ent was acknowledgeXbefore me The forgoing instru ent was acknowledge before me this L day of 20by this_r_day of 20by r� nEe A (Name of rson acknowledging (Name of person acknowledging d (Signature of Notary Public-State of Florida) / (Signature of Notary Public-State of Florida) / Personally Known OR Produced Identification V Personally Knownoduced Identification Type of Identification Type of Identific . n ` �, Produced L-1 Produced e`= KAREN'S. N1E =a Commiorida- LSRN ��`PJP'% KAREN S. NI €€N =;,�o,F�ois may, Notary publi Commission Q`as� °°�- orida-Ndt� Nblic Commission No. ��„ ,.a MY Corr Ion G 207484 =' 'a Commission # GG-207464 Juno 12 n _xPires M Commission Ex ires X22 ill �P uno 12, 2022 REVIEWS RVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 7/2014