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HomeMy WebLinkAboutBuilding Permit Application i ALI.APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION Nt1 TO BE ACCEPTED j(� Hate:j`61 I J i Permit Number: to -()qA 8 Building Permit Aplification Planning and Development SerWces Building and Code Regulation Mision 2300 Virginia,venire,Fort PierceiFE 34982 Phone:(772)462-1553 ,Fax:(772)462-1578 commercial � Residential I PERMIT APPLICATION FOUR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: S v c4zA o 2. i-t 4 SGL E(o Legal Description:_'l� r1_ �� '-goo ��0/0 i Property Tax ID#f: Lot No. Site Plan Name: Block No. Project Name- 1 Setbacks 'Front Back: Right S€de: Left Side: ' 4 DETAILED DESCRIPTION OF WORK: Rowtovc C-v(5 �T, tla-» tq�to, ad-t-/i5/zzl( -pe incl" 20&10akc ff © 1 X13 CONSTRUCTION INFORMATION: Additional work to e-nertonned under this permit—check all t=apply: E)HVAC Gas Tank []Gas Piping _Shutters Windows/Doors Ulectric R Plumbil g nSprinkiers I�I Generator 0 Roof Ramat prim Total Sy.Ft of Construction: SQ.Ft.of First Floor: 1 Cost of Construction:$ Utilities: Sewer L ISeptic Building Height- OWNER/LESSEE: artr(lor,,M&yyCONTRACTOR: Name �' Q r 1 !I Name: Are s��11 O t Company: fL (1 A City..__ V� � State:R,a Address: 11� Zip Code: Fax:1 City: Al((.i MA Stater, Phone No.' I Zip Coder j j Fax:c E-Mail: i Phone No. - Fill in fee simple Title Holder on next page(if different E-Mail:ci 0-fiC � �,t�'t from the Owner listed above) State or County License-.� If value of construction is$2SW or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION . DESIGNERANGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Dame: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: i FEE SIMPLE TITLE HOLDER: i _Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: Address: city: I city: Zip: Phone: I Tip: 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 instailallon'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 1 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 comm 'n 'n our Notice of Commence a ner/Lessee/Contractor as Agent for Owner Sign ntractor cense Holder STATE OF FLORIDA STATE OF FLORIDA COI.lNTY OF + G ®� COUNTY OF osce©Ca The f in ins tr rt ackriowled a fore rrte The for oing in t }�cknowg fore me thi� day of yM 20 by thi!a day of �J C.� 20 0 by owaly- 4&4VQA4den,7_ Name of person making statement Name of person making statement Personally Known OR Produced Identification Personally Known OR Produced Identification Type of id do I Type of Ide�trion ProduceCJ' 1�5 r7G�. Produced / l(�fS �G� (Signature of N t ry Public-Stade; of Florida j {Signature of No Public-State of Florida j Commission No.. GE ILIZABETH CANALES Commission No. "�'�" ( INA ELIZABETH CANAL NotaryPublic-State of Florida �a". Notary Public-State of Florid `�� ••;�M10", Commission q GG 124400 1 1 j�`� i ' ' Commission a?GG 124400 . : 1 "l f �h v r My Comm.Expires Nov 11 202 42 '1•'' ISonJedlhrou hNationaftlaryAsso. """"" tion __9hNationalNotaryAs REVIEWS FRO PLANS VEGETATION 7SEA -COUNTER -REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED HATE COMPLETED Rev.8/2/17 I