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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MLI§1 BE COMPLETED FOR APPLICATION TO BE ACCEPTED i i ��►- aaa� Date: � 1 � f Permit Number: \� ERECEIVED Building Permit ApplicatioP 1 2018 Planning and Development Services Building and Code Regulation Division CeLa�cy, Permitting 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential v PERMIT APPLICATION FOR: Q PRQPa�ED INPRaVEME aCATIC)N: Address: Legal Description: ', ,b\Q\51(-)n I� Property Tax ID#: 3�� 5�k— OD — U v — Lot No. Site Plan Name: U SG IA!!�_ as( &)C'q_ Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DE ILED D SSC �IPTION t�F 1N©RK v� e, A V LIS UrDCA ,e6 s -e S w -�Io \ C, CON4 TR+UCTiON INFO'RiMA ION: Additional work to be performed under this permit—check all that appy: Mechanical Gas Tank —Gas Piping _Shutters _Windows/Doors Electric- _Plumbing _Sprinklers Generator _Roof Pitch Total,Si jfof Construction: Sq, Ft. of First,Floor: Cost of'Constru,ction:$ _U 510 rUtilities: r _Sewer`r _Septic Building Height: OWNERJLE�SSE : C©NTRACT�R: Name G S Name:- n Ccr Address:-!_:771( , CAL n��S Ln Company: City} I State: ��— Address: "Tay 0(�ills L U ZiP.:Code: ( � City:Fax: ' .: Pr'CA State: t✓ Phone No. 3?((� Zip.Code:3S Fax: E-Mail 'Cs S Q crkseOnr� kc� ('VI —Phone No�� v� �J`/ Fill in fee simple Titl Holder on next page(if different CV E-Mail C.., J !^K S C II1 �Jl�^ from the Owner listed above) State or County License CL ����5� If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUP'PLEMEN ALCQNST UCTIN LII`I LA1AT00 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: X Address: City: City: Zip: Phone: - Zip: Phone: OWNER/CONTRACTOR AFF.IDVIT: Application is hereby made td'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. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contra cto /License Holder STATE OF FLORID&� FLORIDA—, COUNTY C COUNTY OF The forgoing instrunt was acknowledged before me The forgoing instrume pt was acknowledged before me thisday of 20_ by this"day of 20_ by Name of person making statement. Name of person making statement. Personally Known X OR Produced Identification Personally Known OR Produced Ident ica ion Type of Identification Type of Identification ^i; Produced N Produced _ z Z` _� g Z_ ii �p V r1.77t i I" L W VII N 'Q W lA 11 r J'A vNi (Sign tore of Notary Public-State of Florida) Mw (Sig ture of'Notary Public-State of Florida) Z E o iia E E un C,v y,'`K T m Commission No - Q (Seal) ¢Z � Commission No (—���� � (Se I) ...� :u�. .,�o� REVIEWS FRONT ZONING PLANS VEGETATION SEATURT.LE MAN96 E COUNTER REVIEW R . „ fi7 REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 8/2/17