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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: a Permit Number: RECEIVED AUG 2 92018 Building Permit Application Planning and Development Services ST. Lucie County, Permitting Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)46271553 Fax: (772)462-1578 Commercial Residential 4;; / PERMIT APPLICATION FOR: - CC Q PROPaSED INPR®U/�EME' 'T LO�A7IQN: Address: T4 P\P-cce. 9 `_ Legal Description: 1{\ of x– ::: ( Itel ntcg3 Qd. Property Tax ID#: aD _j am t ®( b — Lot No.� Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: QETAI=l.ED DE�SfkPTi®N' FOR C (N e_ stn 6Yva 7 S-C , �►l:. 'r-e. Ict C-NSTRIJEKE l.O.N N't=®R11/IATt®N:: Additional work to be pertormed 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: $ Sjn Utilities: —Sewer Septic Building Height: Q11U{{NER/LESS"E: N6 LROOT Name �C-AcJrA— CACNOAa Name: Address: © .Company: City:_:I�A • 21 ec CP Stater, Address: Zip Code: Fax: City: State: Phone No. A2t11)1 2L011_ Zip Code: Fax: h( E-Mail:�eA�'�i {m'_0- *Yr\ A, C_U� Phone No Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. EURPLEME TAl_ CONST tUI®N 91i LAW W11 RMRTIN, : DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zi.p: 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 recording our Notice of Commencement. + ignature of Owner/Lessee/Co rdicaet6r as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 3 COUNTY OF The�foToing instrument was acknowledged before me The forgoing instrument was acknowledged before me this ` day of d.o� 20_ by this day of 20_ by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public9 State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identificati n Type of Identification Produced �' `-- �pMAR1EG���X023 Produced 0 Y FU ���. MyCOMIllSSION `G6 2020 . Commission No. -SPub�1Cunaerv+��e Commission No. (Seal) "sN �, it gonded"(hn+N°tary - REVIEWS FRO T ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER." REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVE_ D DATE COMPLETED ev.