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HomeMy WebLinkAboutBuilding Permit Application r All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r Date: 1 Permit Number: RECEIVED .Building Permit Applicati n OCT 2 9 2018 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: 1-0 I C_ U . Legal Description: Property Tax ID#: "1 J�' b 0�' ' © _ Lot No. Site Plan Name: Block No. Project Name: 0 aOr t�K+'S Setbacks Front- Back: Right Side: LeftSide: r_A6Ve_ 4.n r 4 4J® �X ar boors q4 � rhah,.-QL_s =171onal work to 7e peTor.mePd MunPertPis ermit–check all that 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:$ 6 �� Utilities: —Sewer * —Septic Building Height: Name M%h'n'� Qt^,e Name: �'OSe - -� �^ Address:3/03 7M,o c_ 1-34,W.' Company: 14A"7.-.f <�iar� C'cv _ZfirC' City:�a '_4 "'_- " _ State:/Z Address:706Sbo 6.1 Q6S Zip Code: Fax: q City: affi S/ /Cec• State: Phone No. 77.L Zip Code:va�� Fax: 772 yG I( 2 yo E-Mail: Phone N 7�L- �� a yo Fill in fee simple Title Holder on next page(if different E-Mail 2h�%t �Gh17Zi- ��w Cjs �f SCA from the Owner listed above) State or County License CAcb311.-9 y If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. `f 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 the ermit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules,bylaws or ancovenantsthat 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 rer.9rding your Notice of Commencemen . S' ture of O er/Lessee/Contractor as Agent for Owner Si ture of Contr or/License Holder ATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF 15jd— Lo t ,-7�4 The forgoing'instrurnent was acknowledged efore me The forgoomg instrument was acknowledged before me this 1s,�day of tDor .204 by this ZS day of 6 c�t� - .20J�_5y (Name of person a knowledging) (Name of person acknowledging) (Signaturd'of Notary Public-State of F ida) l (Signature of Notary Public-State of Flo a) Personally Known OR Produced Identification ® Personally Known OR Produced Identification Type of Identificatio Type of identification Produced �y .�..u.,,or Produced �L ,����,�,•�,,, Commission No. (Seal) K Commission No. (Seal) REVIEWS FRONT ZONING 3�Im PLANS VEGETATION SEATURTLE m COUNTER REVIEW REVIEW REVIEW REVIEW m` •1�1dE DATE mm RECEIVED =c'o c ZZ c'a Q DATEND w'`o w. COMPLETED v' m N�o Rev. "Vao Va_O n � Z