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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO Must BE COMPLETED FOR APPLICATION TO BE ACCEPTED `. Date: `�Ia.��`G Permit Number: 10�°� y RECEIVED .Building Permit Application OCT 2 6 2098 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: Address: 0". J >f Vt' Legal Description: Property Tax ID#: A 3.a'1 C'1a qday- 43%D . . Lot No. Site Plan Name: Block No. Project Name: s'J eor '��1p G.c��.:lty►-ems 's Setbacks Front Back: Right Side: Left Side: oVr,__ 4 c,& © ��ro'C oo f s Put �1`C� . itlona wor to ape orme under this permit-c ec 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:$ no Utilities: —Sewer —Septic Building Height: Name Dr Vis Name: �3 D5'P_ )N ' aT17— Addrers �is:, °/ 0 )4Q,yWDo1� `br�ye. Company: n s7� C6 _74C ss , City: ` D r4 �t t�Ge� State:f L Address: l �cS�a 6' ��s C`•-4-0�� R� Zip Code: Fax: City: Or+L�_S �-�-'� Stater Phone No.77 �ZL /X22 Zip Codes 37 c�7 Fax: 722- 46y-2yO!Y E-Mail: Phone No 7L' -416 a yo y Fill in fee simple Title Holder on next page(if different E-Mail he i CO z oo. COA from the Owner listed above) State or County License C_1.x_03 a. If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. 1 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 theermit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules,bylaws or an9covenants 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 r record' our Notice of Commence nt. Z4�_�. /z Si ure of Ow ess Contractor as Agent for Owner S' to Contra License Ho ATE OF FLORIDA STATE OF FLORIDA COUNTY OF .Sfi' L.&aec; COUNTY OF The forgoing'instrument was acknowledged before me The forg Z jn . g instrument was�cknowledgec efore me this day of Ld cl .20�Yby this ay of 0c, .20-P by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public-State d0o.ricla) (Signature of Notary Public-State of Flor&) ) Personally Known OR Produced Identification �� -Personally Known OR Produced Identification -Type-of Identification Type of Identification Produced 1•� L duced �-- Commission No. (Seal) = mmission No. (Seal) REVIEWS FRONT ZONING SU PLANS VEGETATION SEATURTLE COUNTER REVIEW R EVIEW REVIEW REVIEW DATE too= RECEIVED m='�m y=Q DATE mmQ2� rn= W C)o c COMPLETED ^Fo T ^'m c'Z M ev.