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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: I0` . a�1$� Permit Number: • RECEIVED Building Permit Application o�fi 2 6 zM Planning and Development Services ctIA9 . Building and Code Regulation Division ST,Lucie Courj�� Pet1i 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: r 1 �.. �((� � 4Q`b Legal Description:6 A m - roV cv c�7 b` (4 Yt' -� 2� i� �� 35 0 "off Property Tax ID#: 10 ' 50- "10- 3,i" 00(::)-CT Lot No.2- Site Site Plan Name: Block No. Project-Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: .. r1�u7 •�� i•,i:.(�1G�U' �• c�,nc��- �- ��evJ �r�-+'1 C�e�-�� C__ CONSTRUCTION INFORMATION: Additional wor to be nertormed under this permit-check all appy: HVAC Gas Tank ❑Gas Piping _Shutters. Q Windows/Doors Electric 0 Plumbing Sprinklers Generator Roof. ., EARoof pitch Total Sq. Ft of Construction: 1 q j S . Ft.of First Floor: Cost of Construction:$ ��J�� Utilities: Sewer Septic:,,,,,.:. Building Height: OWNER/LESSEE:. CONTRACTOR: Name -�ryv_, R�e�1-y�- f S rA�✓'+ Name: Address si- Company:: City: ► iU�`Gr State: RAddress:._ % . lrl "'cv' ' i�➢�r� I? Zip Code: Fax: City: Ffi l i zYcP State:_ Phone No. Zip Code: 45 Fax: . E-Mail: > Phone No. U1~ _1 4-61 1 Fill in fee simple Title Holder on next page(if different E-Mail: %wrAl oc. vc! r from the Owner listed above) State or County License: 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: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Vhonet Zip: oPlidnei FEE SIMPLE TITLE HOLDER• _Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Pho e; Zip: Ph ne: OWNER/CONTRACTdR 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 Commencemen Signature of Owner/Lessee/Contractor as Agent for Owner Signatur o tractor/License Holder STATE OF FLORIDA1 STATE OF FLORIDA COUNTY OF 5 L- ud f-, COUNTY OF C5-1 �" L lk-ci The f2orgg,ping instrumen was acknowledged before me The forgoing instrument was acknowledged before me this'o47 day of ©CA 20k by this day of Qe• ,26 P by r✓ z c.l�'Y � � � h Name of person making statemetit Name of persou making statemen Personally.Known' � OR Prod ed Identification. Personally Known OR Produced Identification Type of Identification Type of Identification Produ Produce * Com lonj GG 115298 o� fires (i e 5 2 1 (Signatur o ry Publi tate of Florida)' r (Signatu o No Pub i - ate of�FFIo��da) - RAE COURfT � Sion No. a Fys DEBORAH R&pplMNEY Commissio Commission#GG115298' (Seal) Z' Commission#GG 115298 • . Expires une 5.2021 Eq*es Jum 15,2M �' of f�°�� Baaeamu e REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW' REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17