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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ` 5 Permit Number: RECEIVECD Building Permit Applicatio I AUG 15 2018 Planning and Development Services Building and Code Regulation Division ST. Lucie County, Permitting 2300 Virginia Avenue,Fort Pierce FL 34482 Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential_ / PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line 8(313 's WOK: H Address:-( aQ l ILO�tc�1. 9< tri es W.C1 -- Legal Description:__The.i_c3tiCS Property Tax ID#:alp(3�J ?01 C 0094 oOC) Lot No.((. Site Plan Name: Block No. Project Name: atCU �Iti fi� �ULS Setbacks Front Back: Right Side: Left Side: �t�ona wor o e e orme un ert is permit-c eck all that appy: HVAC Gas Tank Gas Pi in Shutters 2_Windows Doo - UElectric Plumbing Sprinklers Generator ]Roof Total Sq. Ft of Construction: S Ft.of First Floor: Cost of Construction:$ 5 9 3 3-5:5 Utilities:Sewer a Septic Building Height: Name�� i�C. �n e. L�rU�S Name:" 414 l�`�� �)ct -_ c��• c e E Address: La 6 k KLn Val ?Qlr•r, S W QA Company-7a i cn QcL f''Cs{&4C �•�-� C'_ City: E'd c•� (���c C� State: Address: to -1 Tfi 01 Zip Code:3 k2 8 a Fax: City:IL C-,CJ , State.-_FL Phone No. f7g2-&A#-90Y1,1 Zip Code:3Sy I a-- Fax: 5L•1 •ass•�vs E-Mail:4Qj {�'j P bw N1,,piwheo,Own Phone No. fbj- 'R S5~- !�-J(-):� Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or County License: 01 G 0©aa.�53 t I f value of construction is$2500 or more,a RECORDED Notice of Commencement is required. r{ mi 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: 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,buiid 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 b'e'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. Si atur f Owner/Lessee/Agent ture of ContractorjLicense Holder STATE OF FLORIDAATE OF FLORIDA COUNTY OF �� COUNTY OFG� The f oing instrurjZent was acknowledged ore me The forgoing instru ent was acknowledged before me this day of ^, 20 �y this day of 20 by �'- (Name of pe n acknowledging) (Name of person acknowledging} (Signa ary>61[c-State of Florida} (Signator of Notaryubiiicc-State Florida} Personally Known OR Produced Identification_ Personally Known___ZOR Produced Identification Type of Identification Produced 4-1.!D Type of Identification Produced Commission No. lCy f , ea BRITTANY E.MORROWo tssion No. (Seal) PaY°�@,1�;r. oSPRY P�@rte ANGELAYOUNG Notary Public-State of Florida = n * t c efl # GG 037 go MY COMMISSION#FF 951069 =a .ai M Comm.Ex ares Oct 10,2020 N az EXPIRES:April 12.2020 Revised 07/15/2014 '";F �'' Bonded through National Notary Assn. Y'�of,oQ� FwndedThruBuagezNataryssrces REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS _ _