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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED tri Date: / Permit Number: U r RECEIVED ' DEC 0 6 2018 Building Permit Application Planning and Development Services ST. Lucie County, Permitting Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: 90nn i-e- an J A4 A a 1;,-, yY1 p re e, PR'•POSED b P� :QUEM NT LOCATIC}N: Address: 467- & 7 COO e J),t fcr q o S Legal Description: Lo+ /D 7 3free� Calk Property Tax ID#: t CrJ` �. 1 d n©) • Q 6c .5 Lot No. f�7 Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DET'. SLED DE�SC�RIPTION t•7 WORK: 30-Uen I n F/z-L FF-o n-r end 6e7ck /-3 ec k CONSTR�UCTI• =T1 : Aaditional work to:l5e.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: )08 Sq. Ft. of First Floor: Cost of Construction: $ 6210 U - Utilities: _Sewer _Septic Building Height: 0 NRA ffsgEE: ONTRA •R: Name-%-,x&A N ,'C;, 0 ,Name: S IAME;0,1@017AA INONATRUCTION TEN W INFORMAT O►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 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 wor or recording our Notice of Commencement. � A / Sigature of Owner/Lessee/Co rac r as Agent for Owner Signature of Contractor/Licens older STATE OF FLORIDA STATE OF FLORIDA C COUNTY OF i . Lhe,G lE_ COUNTY OF LU The forgoing inst ment was acknowledged-before me The forgoing instr ment was acknowledgeefore me this JP-day of 20ff by this�day of ` 20 t' by V �`J W� \4� i Name of person making stateme t. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced-identification Type of ldentVie&tion Type of Identifica Produced i Produced F AA (Signature of Notary Public Signature of Notary Public-State of Florida) `��"yp'F/, KAREN S. NIELSEN ?=o`FR U� ;St Florida-Notary Publ c Commission No. `�� ommission No. Klr �� S. NIELSEN _ *� C mm ssion #GG 20748 """�� +� ops My Commission Expires ?=o, P�A��;State of Florida-Notary Public ,,F Commissi.on#GG 207484 11 OF Fro y Ane 92, 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION � COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17