Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Las Building Permit Applica ion AUG 3 0 2018 Planning and Development Services Permitting Department Building and Code Regulation Division St. LUcI COU nt FL 2300 Virginia Avenue,Fort Pierce FL 34982 �o Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential 4/ PERMIT APPLICATION FOR: PN,OP.0SED INPROUEMM,I LOC ilIs " Address: Legal Description: Property Tax I D#: ` Z ' �� '�ddZ' ��� Lot No. Site Plan Name: Block No. Project Name: 'Fd 51a1�ze,1 ' Qir-Par (oT Cgat.na&.1 or f7���Z��� Setbacks Front Back: Right Side: Left Side: D TAILED DENORIPATI IQ . OF WORK: c� 'T Leadi UP4 4) W12 ErJ �' C©NSTRUCTI0101I �ORMATiON: Additional work to be pertormed under this permit—check.all that appy: _Mechanical _Gas Tank —Gas PipingShutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost.of.Co:nstruction: $ Utilities: _Sewer _Septic Building Height: OWNER/LE=�S�S�E; CONI"RA OR. . , �. Name nsa "�qq ouo Name: Address: ] L IS (` Company:f]AJ u U.)A--r—fPr-5 City: [4 State: : Address: 1 � Zip Code: Fax: City: �St��2 fy l Phone No. �����3[``� 779 1 Zip Code: `Fax: z— E-Mail: Phone No —LICLP 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. it SUPPLEMENT L CONSTR�IJCTtON LIEN LAW IN�FORMATIQN: 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 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 commencinwwork or recording our Notice of Commencement. Signatu a Owner/ ess a/Contractor as Agent for Owner Signat re Contr ct r/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF *' COUNTY OF The f r oin instr ent was acknowled ed before m °q;•••� ' g g g *,,. The forgoing instru nt was acknowledgq before.m •....• .� „w this day of 20 by �, thi day of 20 by m " T/ op— Name of person making statement. ame of person making statement. M�'M w � �Q P3 / �wgc Personally Known OR Produced Identification s� ersonally Known OR Produced Identificatio Type of Identification a;� ype of Identification Produced �N roduced oA (Signature of V ary Public-State of Florida) (Signature of No Public-State of Florida) Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 8/2/17