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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO)MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 Date: / a' N. Permit Number- / 2' o3 ••••• RECEIVED LMAMA ' DEC i. 4 2018 Building Permit Applic tion Planning and Development Services Permitting Department Building and Code Regulation Division St. Lucie Cou FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial -Residential PERMIT APPLICATION FOR: P OPOSED INP O1/E EN// LOCATlO Address: ��d /�c�/E� 9 Legal Description: Property Tax ID#: / • -3Y 7 © � �" d ' J Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAIL D DE�SCR;I� TION OF WORK. A-1 CONSTRUC lO'N (INFORMATION: Additional work to 3epertormed. under this permit-check all t at.app y: _Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors K-E-lectric —Plumbing _Sprinklers —Generator —Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ Utilities: _Sewer _Septic Building Height: OWN fR/LE�S`0EE• CONTRACTOR• Name Com/ Name: 12c1 "A Address:oZ .3 C) ����lv Company: 1 o!�S"o2/ �l�G /I i City: r::t}//� �e State: Address: ��3�! Sc' cl—CIA t�✓L�( Zip Code: 3 ,(i/ Fax: City: ,S L State:_z5__L Phone No. Zip Code: Fax: �i E-Mail: Phone No Fill in fee simple Title Holder on next page(if different E-Mail AMA_45- from the Owner listed above) State or County License t"C 1300 73 0 C If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLER WT A CONSi`RkJCTI©N l:IfaN i.AW PN `'t RMATION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable 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 twic improvements to your property. A Notice of Commencement must be recorded and posted on the jrte before the first inspection. If you intend to obtain financing, consult with lender or an attorney befo commencin. rk or recordi our Notice of Commencement. a W S� Z �g. ature of Owner/'L'essee/C ctor as Agent for Owner Sig at of Contor 'icense of ¢�X iE >-W g STATE OF FLORID N m ATE OF FLORI COUNTY OF W d COUNTY OF- The '� The for oin instr ent was acknowled ed efore a �4 The forgoing instrum t was acknowledged efo =0,0 a g g g „*311 this day of 1 G 20 t by m o� this day of 20 /y by W zW Z Obc� m S n Quo--g Pu8er, Name of person making statement. m Name of person making statement. Personally Known OR Produced Identific i '1 'b°e Personally Known OR Produced Identification Type of Identifications ��°= Type of Identification -•,�.tet•. Produced Produced (Signature of Notary 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 Re—v.8/2/17