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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO JUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: U Permit Number: VIO`E D REC ®� M � Building Permit Applical ion AUG 10 2018 Planning and Development Services Building and Code Regulation Division Permitting Department � 2300 Virginia Avenue,Fort Pierce FL 34982 St, UC aunty, FL. Phone: (772)4.62-1553 Fax: (772)462-1578 Commercial Res PERMIT APPLICATION FOR: IL , PRQPOSED INPR01/EME T LOCATIO'fV: Address: 6o I ex Legal Description: �M G r-O\Te, S V.11 L LDL I I cm . c v►-y �536� a.�l � PropertyTaxlD#: V - 5 031 0Tg9 000/b Lot No. , ' Site Plan Name: � iBlock-No.. L Project Name: L ) Setbacks. Front Back: Right Side: Left Side: DETAf@@ DE�SCR'4PTI©N OF WORK: fin. i cc 0 d' J `D erf V 1 N CONSTR�UCTI�N 1NFOR�MATION: Additional.worto eperformed under this permit-check all tat app ys. Mechanical _Gas Tank _Gas Piping ,Shutters - _Windows/Doors _Electric Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction Sq. Ft.of First Floor: ff � ``y 02�� Cost of Construction:$ � l' Utilities: Sewer _Septic Building Height: QWNER/ 1 CONTRACTOR: Name n4- i n Name GiAS4 W IV i lwoq - Address: �9 1 gleX qnJ f o\ Cit`- C p y (�3•Cc��y� 2,`�V 2 G� City: = �)�errC State: Address: 110C_ L�gSY /p Zip Code:3`"��gr� Fax: '-! City: FT1�`��F11 State:, Phone No. (�U�- ��� - S$�� Zip Code:1, 9ci$ d- Fax: E-Mail: _ Phone No 77 - 1 - 6`1 c4 Fill in fee simple Title Holder on next page(if different E-Mail �s�'u��'S G, w'l.% from the Owner listed above) State or County License a.°'1 -az If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUP PLE(UIENI'AL CONST-R17�1"k©N LIEN LAW I FQR111/IATI,U►N: DESIGNER/ENGINEER• _Not Applicable MORTGAGE COMPANY: Not Applicable Name: U-+-14-ce 6 _ Ti W,+ Name: Address: 649_,5 AJ-W: 'M SJ sort-3 DS Address: City: ut' '� U-W'Oil BnS State: " , City: State: Zi P:, 1'16S Phone I 0, -- 7.1 - t S`3D 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 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 recording our Notice of Commencement. Signature of Owner L see ontractor as Agent g / g ci ;�u Signature of Contractor/ ' ens older STATE OF FLORIDA m< STATE OF FLORIDAJt COUNTY OF $ �1i7s� COUNTY OF RXm The forgoing instrum t was acknowledged bef igr m The for oing instru nt was acknowledge be this day of i� 20_ b A sg this day of 20/ e m C: p,T= Z cn m 6 �' e 7a\1 p C �� -�6tV e cz- g= (Name erson acknowledging) (Name of person acknowledging) �N (Signature of NAtary Public-State of Flc;rida V / (Signature of N o ary Public-State of Florid ) / Personally K n OR Produced Identification Personally Known OR Produced Identification Type of Ide tific do A Type of�ldent is o /�/� /�� Produced a I' Produced o� 01 J� 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