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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: d1 \ce, Permit Number: V�dq^ ter-. RECEIVED _ Building Permit Applica ion SEP 0 6 2'18 Planning and Development Services ST. Lucie County, Permitting Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: v PROPOSED IN'PRO�/EM�ENT L®CATL.* N: . Address: Legal Description: Property Tax I D#: \"J Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DfTAI�LED DE=NS.•R+IPTI©N QF WORK; c Q e ��?� r c1 in e ovr 92- tC)PI Y Sem cfL Ca G un� r O LW �2-�oc�O �trrt • Add C©NSTR�UCTION INFORMATION; itiona I work to be-p-eirfo-r-m-e-A 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: $ 3,�© Utilities: _-Sewer —Septic Building Height: OWNER/LE-'SSEE: CONTRACTOR: Name o i2 4eve Name: lm e., Address: �s ��ls �eS Company: 6 City: �i��GC State.L Address:. Zip Code: �c`( 1�f T'(F�a�x: City: e -rm e'e Stater Phone No. / 7� .32--3 °�F Zip Code: -7Z Fax: E-Mail: Phone No 772 q 71 =1 f4 Fill in fee simple Title Holder on next page(if different E-Mail fm v/`lee 0 iG (ov -r COIYY­� from the Owner listed above) State or County License C4 e aYJ If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SSU LEMENTAL CONSTRUCiTfQN PEN LAW INF4RMANN ON: 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 pro erty. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection If y intend to obtain financing, consult with lender or n at y before commencingwork or re rd' our Notice of Commencement. Sig ture of Owner/Les ee/Cont ctor as Agent for Owner Inature of Contractor icens older STA OF FLO I A TE OF FLO DA COUNTYOF . Ly c�-C UNTY OF � The forgoing instrument was acknowledge before me The forgoing instrument was acknowledged efore me this day of 5 Q c 20 1% by this � day of 'Sk$± 20 by �►•�.aA-�� Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identi ication Produced 1. L— Produced L L- (Signature of Notary Public-State of Florida JDO?3 (Signature of Nota � EGivENs GIV ,.D #G °' + F MY COMtJIISSION.#GG 022023 Commission No.� ON t"O pIRES:D, 1s,2o20 P,RESNpb� Commission No. 're ,oPc BondedThNNo ry�DIICUnde�wrlters !°�:,. REVIEWS FRO G SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUN R REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17