HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED f
Date: �`� Permit Number-
RECEIVED l V S�
. . RECEIVED
} Building Permit Applic tion OCT 17 2ot8
Planning and Development Services Permitting Department _
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial* Residential
PERMIT APPLICATION FOR:
Address: !a SE l v� C
Legal Description:
Property Tax ID#: 5 4r 6-5-G ,�rCIIQ 7 GeQ. 1 Lot No.
Site Plan Name: `� r V Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Additionalwork to be performed under this permit–check all that appy:
_Mechanical ` Gas Tank _Gas Piping _Shutters _Windows/Doors
7
Electric )CPlumbing _Sprinklers _Generator _Roof_ Pitch
Total Sq.Ft of Construction: Sq. Ft.of First Floor:
z.r, • ��:a, Utilities: Sewer
Cost of Constuctio.n:,$. _ Septic Building Height:— —
Name :.. Name: "Q X0
Address: r' kv, Company: f- f1/►'1 '�
}
City: � Cly State: Address: % / (A e .�'
�
Zip Code: 3 Fax: "`_ City: /V00.ka- State•
Phone No. ? – 979 — .qO Zip Code: T .,Z ? Fax:_07
E-Mail: Phone No _ 3q�'Q
Fill in fee simple Title Holder on next page(if different E-Mail 14-4PE 9
from the Owner listed above) State or County License C FQ 1 � -'N
If value of construction is 2500 or more.a RECORDED Notice of Commencement is reauired.
Si
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 BON DING•CbMPANY: _IVo:k Applicable
Name: Name:
Address: Address i
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.Lu.cie.Countyy makes no representation that is granting a permit will authorize:,the.permit holder,to build the,subject structure
which'is in con, i'ctwith any applicable Home Owni rs'Association:rules,bylaws.or and covenants that ma_g strict or prohibit such
structure.Please consult wrth'your Home Owners Association and review your deed for any restrictions which.may apply.
In consideration of the granting°of this.req uested,;permit,I do hereby agree that I will,in all respects,'perform the work
in accordanco.withthe approved plans,the Florida Building Codes and St:Lucie County Amendments.
The following bililding permit applications are exempt from undergoing a full concurrency review:room additions,
:accessory:structures,swim ming,pools;fences:walls,signs,screen rooms and,acce'ssor'uses to another'non-residentlal use
WARNING TO OWN.-M Your,failure to Record`a Notice of Commencement:may re ult in your paying.twice for
;improvements to your property:A Notice,of.Comm.encement must,be,recorded and posted on the:ibbsite.
before the'first inspection. if you intend toiobtain financing,-consult`with lender or an at before
cornmencing work-or recordilig your Nofice.of'Commencement-, Ali
Signature of°Owner/Lessee/Cont ctor.as Agent for Owner Signature of`Contractor/License older
STATE OF FLORIDA. STATE OF:FLORIDA
COUNTY OF .E-= t `'Q' COUNTY OF X 1MI JI( 'r\ t ,Q
The fo oing instr�{nen wa acknowledg efore me The forgoing instr me t as--a-c, before me
thiel dayof V 20by this�dayof i' 20by
•
Name o person makingstatement. Name-of person,makingstatement.
Personally Known. . OR Produced.identification PersonallyKnown OR,Produced Identification
Type of IdentificationType of Identification
Produced Produced
(Signature of - r d_ jSignature of'.ota StMotsf iW9bVt�WcfFW!da
,trt tloLaryPu6licStWra. Florida POrllela,l: tBFFIppE
Commission:N . =� Pamela Dyer-H�,•
laslond8t15, Commission No t�yl�t�s
REVIEWS FRONT, ZONING SUPERVISOR PIANS VEGETATION SEA TURTLE MANGROVE .i
CbUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE -- -
RECEIVED
DATE.,
COMPLETED - ,;