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HomeMy WebLinkAboutBuilding Permit Application All APPLICABL INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Numb a. a . rx. RECEIVED - DEC -3.2018 _ Building Permit Appli tou Planning and Development Services Permitting Department Building and Code Regulation Division St. Lucie o ty, FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: Fen ce— A idyl . 12,18'M W95 EP @1 IINPROVEMENT LOCA ION: Address: U S 6�2' Pin of Legal Description: Property Tax ID#: /� _ �V/��� — "I Lot No. p Site Plan Name: !� � %6r �n/F O Block No. � Project Name: Setbacks Front Z Back: Right Side: Left Side: DETAILED DESCRIPTION Of WORK: iS ,Rvl c �aYner�. 4w it I 2 f r C©N5TR�UCTION INFORMA I©N: itiona wor to 5e performed uncler t is permit—c ec a tat 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:$- ���, ✓D Utilities: _Sewer _Septic Building Height: 0CNERR L@E: ANTRA OR: Name 4J�-w Name: Address: Company: City: Yflp-C L State:2. Address: Zip Code: 3�(oS_l Fax: City: State: Phone N 7 SC' —C» Zip Code: Fax: E-Mail: -T !d P lee'pl--i Phone No Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENT'` ,�.CON57FtUCT1©N FAN LAW 1N�0'Rft/fA1'IC� ` ; x " ; MM 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 lender or an attorney before commencinR work or recording our Notice of Commencement. dot Sigpafure of Owner/Lessee/Contractor as Agent f( Signature of Contractor/License Holder STATE OF FLORID_ /Z a�� STATE OF FLORIDA COUNTY OF �` �G/e 2 Ds COUNTY OF o cn-< The forgoing instru gent wa acknowledgedp for rte'Z c The forgoing instrument was acknowledged before me this day of « 20 /6 -b �T= this day of 120 by (f s-s' C 01 Name of person making statement. Name of person making statement. Personally Kn nOR Produced Identification Personally Known OR Produced Identification Type of Identificatio Type of Identification Produced ab t Produced (Signature of Not9b,Public-State of Florida) (Signature of Notary Public-State of Florida ) Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17