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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO pp MUST BE COMPLETED.FOR APPLICATION TO BE ACCEPTED T Date: �� �' l O Permit Number: 1 RECEIVED Building Permit Ap-plication OCT 0 3 20.1 Planning and Development Services Building and Code Regulation Division ST. Lucie Gewnty, Permittiln 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from'dropbox, click arrow at the end.of line PROPOSED IMPROVEMENT LOCATION: (Zr Address: - L70/1 5-Po4 r" CH.,.4 tit LF ,cL 5 E%, Legal Description:' eo f 31 /S'LAV;D Property Tax ID#: 41--. :3 Y-J-Ul -0 175 9,00 -0 Lot No. .57 Site Plan Name: Block No. Project Name:,- Setbacks Front Back: Right Side: . Left Side.: DETAILED DESCRIPTION OF WORK: , ffe�.�� f it c� CONSTRUCTION INFORMATION: Additional work to be nerformed under this permit-check a appy: HVAC G Tank alias Piping _Shutters Q'Windows/Doors aElectric L_�I Plumbing aSprinklers Generator Cl Roof- ' ,Roof pitch Total Sq. Ft of Construction: Sq.Ft.of First Floor: Cost of Construction:$ t ( ©. �� Utilities:[]Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: w.; Name "f i6g� 1f. ,V,0 C440L S,f ,QSO 'Name . P7roi, Address:yfG/I"-�F�4i�Y''G/`f/� e—wa�� Company: ��1(: 5 w..rrt. /GL LLC- City: State:ZL Address: Zip Code:3".Flb, '`FaK City: eor`�' 5�, c)Cf Stater Zip Code: 3 1 S 3 � Fax: E=Mail: /6uc�;SI"� 7t qrna+/. Phone No. 77Z-' �Z�" 1SY Fill in fee simple Title Holder on next page(if different E-Mail: ern(65--5 P ju:'K&J!: _7 tLC EXT40o e from the Owner.listed above) State or County License: C j-=C 14 3,`7 1 -92� If value of construction is$2500 or more,a RECORDED Notice-of Commencement Is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER%ENGINEER: _Not Applicable MORTGAGE COMPANY: _,IWot Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone ;i; 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 commencing work or recording our Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License,Holder STATE OF FLORIDASTATE OF FLORIDA t COUNTY OF 5;7- 4d/G1E COUNTY OF The rgoing instr e t as acknowledge before me The f oing instr e t �as acknowledg before me this day of 20JX by this day of 20b by Name of'person making state4 int Name of person making state nt Personally Known OR Produced Identification Personally Known OR.Produced Identification Type of Identif' on Type of Identific tion T Produced L✓ Produced U V AA (Signature of Notary P, (Signature of Notary Public-State of Florida_) KAREN S. NIELSEN ��rr��'.State ida Notary Public Commission No. c(lsg�l� (Seal) =. .Commissi n #GG 207484 Commission No. -� ' P`` My:Commissi 2022pIfeS ``"�..... %g�„�:`� .lune 12. FN °��`►AyP�°�;=_st KAREN S. NIELS • Com ;nip -te otary Pu li REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATIO "011YI-tRIMEmoi,Cr,AlE48 COUNTER REVIEW; i REVIEW REVIEW REVIEW L ne RZPires DATE 1 RECEIVED DATE COMPLETED F , •Rev.8/2/17