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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED G1 Date: Permit Number• RECEIVED .. • - OCT 2 5 2018 Building Permit Application Planning and Development Services Permitting Department Building and Code Regulation DivisionSt. Lucie Count , FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: PR©PQSE�D INPR©UEMEN LflCAT101'N: Address: ,324D ;r 3Z 5 Z J 7 X Legal Description: 1;04 JZ_4 ✓Z Z_L4 �' X-PE,,/ `/i✓17- 2 Property Tax ID#: Z y Z 7- (0 ®OS-7 - DZD Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DE IL D K g&0RIPTION aF WaRK. - �c7 GUDUD CCS _ gDAl Z 41AJe CQ STR++UCTI;C? , i F©RM TION: Additional work to be pe orme under this permit-check all that appy: Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: /�D i Sq: Ft. of First Floor: Cost of Construction: $ dee*' D D Utilities: _Sewer _Septic Building Height: 01AlNER irl's'n's5 CONTR CTOR: Name ..SQL/D pf J44c, GZ-e_ Name: JIX77) .7 Z✓Ale_�O Address:0076 A/w A14i4A.1 a 4,te i &" Company: X-J':�F-s LL G City: .72F,1S'c-,✓ !9c7-,4 G� State:FL Address: 1,5_0 Z_ .3!✓ /./1 114E--114C*-- 4 Zip Code: 3 cf Fax: City: P State: CL Phone No. k2l- 7 9'&C) Zip Code: _T V'5 -y3 Fax: E-Mail: Phone No 2 7 Z - '57Z Y - Fill-in fee simple Title Holder on next page(if different E-Mail JJ__V ✓Gy e Gew� from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of'Commencement is required. SU''Pl�E�ENTAL C®NSTRUCT'I�N LEEN LAW I� *ORM, � ION: 1 N41 rF, DESIGNER/ENGINEER: - Not Applicable MORTGAGE COMPANY:' _Not Applicable Name: Add'r'ess: � 'Rd✓ Address: City: State: City: State: Zip: 'l 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 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 Commencement. Sign o Own essee/Contractor as Agent for Owner Signatu �ontra / cense Holder �m r�r � STATE OF FL IDA - STATE OF FLORID �T= _m. COUNTY OF I D �! COUNTY OF ` � r�� =gam z . The for ng instrument was acknowledged befor � � The forgoing instrument was acknowledge efor �g Z this day of Q(--� 20 �� by o this ZQTday of0«— , 20 by i X �� n l W -2 ( � w z 1 'f C (� m Name of person making statement. ¢i;a-m Name of person making statement. 2 - Personally Known OR Produced Identific ion m Personally Known OR Produced Identifica Type of Identification ;a4' `'d° Type of Identification Produced j4 Produced (Signature of N ary Public-State of Florida) (Signature of Nota ublic-State of Florid Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 8/2/17