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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: V\a� 3 RECEIVED ` JAN 0 3 2019 Building Permit Applicati n 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 (J PERMIT APPLICATION FOR: PR• `OSED INP� ©DEMENT LOCATION: Address: 1 -7/3 dnat - F/Ctr,6 C/C- h 6 uL-g— t2V2( P 1 e; �=/ Legal Description: Property Tax ID#: 2,3c�3- a��-aaas aa0'S Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETA'LED DESCRIPTION C•}f WORK: rR2n�dye SI'll"n,a1 PS , re.Plac=C Shbig,Ie 5 c)y\ r-od�� C© T CTIO INFQRMATION: jr— itional work to be pertormed under this permit—check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors. _Electric _Plumbing _Sprinklers _Generator oof +i3' Pitch Total Sq. Ft of Construction: 71,3 Sq. Ft. of First Floor: Cost of Construction:$ G? Utilities: Sewer =Septic Buiiding.Height: • M419 Rf E�S�S E: • NTRACTOR: Name 1n l CS'1Ck(!!J IAC tin t_n Name: Address: or H CL r:6Company:- r' City: CZ's)p e rC State:t C_ Address: Zip Code:J Fax: City: State: Phone No. '7'2 Q(4 a 13 3 5 ip Code: Fax: E-Mail: 4hone 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. Sl1PP ENIEN # ,L CONSTRttJCTt{�3N -NLA IN.,�a'RI111AT1�' 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 work or recording our Notice of Commencement. Si naM/, ture of Owner/Le see/Contractor nt for Owner. Signature of Contractor/License Holder STATE OF FLORIDA STATE.OF FLORIDA COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of _,N4 r-- by this day of 120_ by V"* Name of person making statementl Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary P bli ;,, oridBON"' X022023Immission Signature of Nota Public-State of Florida MY COMM1SS10 fiber 16,2020g Notary ) Commission No.&6 tiwS'D� bncundenvnte (Seal)( Notary No. Seal ':r o• BoS1 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.