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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1 1� Permit Number: RECEIVEDb ! Building Permit Application Nov 2 8 2018 Planning and Development Services Building and Code Regulation Division Permitting Department 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:.(772)462-1553 Fax: (772)462-1578 Commercial Re ra ide UC't ounty, FL PERMIT APPLICATION FOR: PRaPCtSfD 1NPR01%EMEIUT Lb:CATIQN -/ ,� Address: S ��r G�iss1-.2 �/'l !-e /�7. /i�'�r� �� 39gq! Legal Description: -X '/®v, oet'sTa les -i%.,- O7 ",6/2. 73 /a/ a� aon/X1 / ,Lo f ,Z3 6663i/1AA ole 25"7-- 2e2-9 QHS 331~ '708) Property Tax ID#: 7�aZ-` 1��� �J©c5 0670 - oZ Lot NoE Site Plan Name: o� Ol7e Block No.73 Project Name: `lOhe setbacks Front Back: Right Side: Left Side: A DETAILED DESCR1PT10N OE WORK ,o/Qc e 15�' 0/a/ kz�4 ws �.� 6i �e� %' r S er-i e s -So ' E CONSTRt1CT1C3N 0 -1 71 ' 'ATI ... Additionalwork to be pertormed 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: Sq.. Ft. of First Floor: Cost of Construction: $ a� Utilities: —Sewer _Septic Building Height: QWNER/LE CONTRACTOR SSEE Name ��H ,� �-i e�CC e%oi a Name: &Agg,7 /Te lSe /l, Address: 5W9 4-'q,S7,S/`4 /ad's`v�e Company: lleAe ,`A J . the City: /c /���ee State: Address: 2yO Zip Code: Fax: City: &, to �/iHsbo� -Ts /ao--J State: /`�L Phone No. 77A6F Zip Code: 399,19 Fax: E-Mail: - — Phone No 77,2 -.214 ` / c3 U 9 Fill in fee simple Title Holder on next page(if different E-Mail ri ayr 6e Is e o-46,-PGv from the Owner listed above) State or County License C'6-0�f - If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. St1PPLE11/IENTAL CQNSTRUCTlON.LIEN 1AW INORMATIQN / — pp MORTGAGE COMP NY: Not Applicable DESIGNER ENGINEER: Not App . �/ Name: -.Name: ;,Address: Address: City; State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLEHOLDER: _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. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA - STATE OF FLORIDA �.CZ4 COUNTY OF COUNTY OF The for 'ng instrument was acknowledge" efore a The f r .ng instrument w s acknowledg oefore m� this day of ! j 20by N� ° thi , D-day of 20� by r� W [L aLLm � r 44 � (Name of person acknowledging) w (Name of person acknowledging) $¢ 2 �a ¢rix g m Nota Public-State of Florida •, (Signature ry ) (Signature of tary Public-State of FI ida) �. Personally Known OR Produced Identifica Personally Known ✓ OR Produced Identificatior .'4' Type of Identification :, Type of Identification Produced Produced 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.