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HomeMy WebLinkAboutBuilding Permit Application ,J All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ci Date: d 'dre 9 Permit Number:AgNO­dz4)G RECEIVED Building Permit Applicat on OCT 2 6 2018 Planning and Development Services ST. Lucie Coun Building-and Code Regulation Division I�f it11IR9 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: Address: rX a 0 -T0 A.ywoo 1) t^i Ye, Legal Description: Property Tax ID#: 1�3�.- 1 d d � Lot No. Site Plan Name: Block No. Project Name: o o r �k4-C12–f),," Setbacks Front Back: Right Side: LeftSide: 'boar's o n g Add tional work to be pe or.med under this permit–cec a tat 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: $ 0 Utilities: —Sewer _Septic Building Height: Name J O-Va Y) �� Name: toy- Address: 2 J'© Q, oo Uri Company: s 'IQ's s �U < City: /��� State:_ Address: G 9��o �` 1 C`''�° r Zip Code: Fax: City:/ej 1�-S7- UZIC State:�L Phone No772— , 332— 22.8,11 Zip Code: l Fax:Z;�Z- Y6 VOy E-Mail: Phone Np7) Fill in fee simple Title Holder on next page(if different E-Mail h;hl) from the Owner listed above) State or County License _02 4 0 If value of construction is 2500 or more,a RECORDEDN otice of Commencement is required. 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 thepermitholder to build the subject structure which is in conflict with any applicable Home Owners Association rules,bylaws or an 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. natur of wner/Lessee/Contractor as Agent for Owner S. a bre of actor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF Sd- l.0 c.,r COUNTY OF 5d— L,.rtr.rr The forpinginstrument was acknowledged before me The forgoing instrument was acknowledged before me this Z day of 26ji by this 1,5 day of QC-r— .2049by (Name of pe on acknowledging) (Name of person ackno ledging) (Signature of Notary Public-State V orida) (Signature of Notary Public-State of FI da) Personally Known OR Produced Identifi °W'lt'' Personally Known -OR Produced Identificatio Type of Identification _ _ Type of Identification Produced Produced Commission No. (Seal) cR 2 Commission No. (Seal) z,'` 3 @ rn to ® 020> 3onm 2 �a30> REVIEWS FRONT ZONINGS R PLANS VEGETATION SEATURTLE Mt�(il17o z COUNTER REVIEW "'I�E�d 1� REVIEW REVIEW REVIEW R M.M DATE N X ib�-n a=G);i RECEIVED 0 N DATE g o COD 0 cc COMPLETED lev.7/2014