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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: I I Building Permit Application RECEIVED Planning and Development Services N Q V 17 9 2 0 19 Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 9Ts �qi@ P-P4 r'F (rT11EF.lfi4 Phone: (772)462-1553 Fax: (772)462-1578 COMMerCial �. Residentla z PERMIT`APPLICATION FOR: PROPOSED 1NPR01/EMENT LOCA Address: 2"/_30 -5, 0 Kt�het�-= Grp Legal Description: Property-Tax ID#: 3 �a �o��J • OC�30' d�� Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: J DETAILED DExSCRIRTION OF WO K: c14 / //"A A) A r l't/ k l"•14 CONSTRUCTION 1!NFOR ATION: AWitional worK to ne peorme+ :;;un ,er't is.permit C ec a tat appy: _Mechanical _Gas Tank _Gas Piping _Shutters _ _Windows/Doors tElectric _Plumbing _Sprinklers Generator _Roof Pitch Total Sq. Ft of Construction: J. Sq. Ft. of First Floor: Cost of Construction:$ k I'I o e, Gu Utilities: _Sewer _Septic Building Height: PINK,NER%11-1 CONTRA OR: Name '?,Name:' Address 17416' S a UL LJt iJ . .' 13s ezpi Company /2.. 64;16tr City: T4,-uSc N �3 "n c State: L Address: �3 L;. Zip Code: Fax: City: E St �L ate:rG Phone No. Zip Code: Fax: E-Mail: Phone No :9a 6 Fill in fee simple Title Holder on next page(if different E-Mail S'�'Jy0A k_r.`b/1!U c 0, from the Owner listed above) State or County License 4-C /3Go 7"7 G /. If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUIPPLEMENTAL C©NSTRUCTIC�?N UEN LAW I MR,MATI®N: 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,thepermit 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 I or an a torney before commencing work-or recordingyour Notice of Commencement. Si a re Owrier/Lessee/Co for as Agent for Owner Si atu of Contracic tgr� ense of ATE OF FLORID ATE OF FLORIDA COUNTY OF S� . \-y<< COUNTY OF S+- Lyc,1� The forgoing instr me t was acknowledge before me The for oing instrument was acknowledged before me this�day of_ d 20 m� by this \ day of 'N 6J 20A4 by- �ob� "�wdm ' sa� Name of person making stateme t. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced I—L. 0 L. (Signature of Notary Pu ic-State of Florida) (Signature ofiVENS NMI.II•• IE G{VENS +ti'p''' �'- COMMISSION#GG 022023 Commission No. p 022023 S'D�m azo ION.1na Commission No 1� ttia,...,• My COMMI t 16.2020 "s� �� Notary Pu unnvriters ';� AIRES: m� Undenvn • `•' .. ondedTW cr. .c blit •'so::t r` Sonde REVIEWS FRO SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUN ER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 8/2/17