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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO M ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 212 o )-_L+5s o& C RECEIVED _ Building Permit Applicati n DEC 12 2018 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: Address: ON �tL°�4h �' ���/ J? �✓� Legal Description: PropertyTax ID#: a�Ll©� Df�d®/� ��� Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left.Side: iO�e f ✓'i l/G c Vn—M. S1d iti.ona wor to e e orme under t rs P p I J _Mechanical =Gas Tank _Gas Pipid Plumbing _Sprinkle - a Electric — I Total Sq. Ft of Construction: .Cost of Construction:$ 100 — ® Util Name-IL / U- �� /C �-Z' .L7 Address: 606 t&Y City:R� )Vl �e`'`G'- State:/C-- Zip Code: ��yy Fax: Phone No. 7�1� '� e E-Mail: S _ Fill in fee simple Title Holder on next page(if different e,cA from the Owner listed above) [ I If value of construction is 2500 or more,a RECORDED Notice i _ W. f� DESIGNER/ENGINEER: _Not ApplicableMORTGAGE 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 accessoryuses to another non-residential use WARNING TO OWNER:Your failure to Record'a Notice of Commencement may result in your payirig.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 1` STATE OF FLORIDA COUNTY OF �`�l,�1 fC'�lF COUNTY OF The fomoing-instrusent was acknowledge efore me The forgoing instrument was acknowledged before me this day of 20jby this day of .20_ by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public-State of Florida) /" (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification "Type of Identification Type of Identification Produced Produced KAREN S. NIELSEN Commission No. ;_° � statelr@�a +�AQnda-Notary Publicl,Commission No. (Seal) CorrFPhlivion #GG 207484 My Commission Expires June 12. 2022 sta�xF.�� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW . REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. V 'MMISR,"N K,Z �� ­�'Aj'. W,v "N" 0%Ao"4M�Mlvwt'N im qv WD RK ag mop w-vil §f, SWAM I JIM lu V;7Ai 'r MN 4 W SO SUMMIT 2 mom E gq� VIL 11 W K.IN 'PiRN, 0,SO Al e'ggl 'Fall �Owg'g­a "UN �wwli V, 4 Ri 61RW ON` Ni'll V, RON�R AIR,, g A NMI MEN, Af