HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
'RECEIVED
JAN 10 2019
-- Building Permit Application
ST. Lucie County, Permitting
Planning and Development Services ------
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: �} � p�7��C/��t� -,
PROPOSED INPROUEME '1'LCATI'ON.
Address: 3115� e Hv� kk- '9 Cccse- -�A 39912),
Legal Description: \A-15 2)01- A LpA�) 9L4 AkN1D, Q to f).`-1� 1bf-
999 1,91 MS
Property Tax ID#: q, C 5 - ('0o I - b 0Qa-b00 -S Lot No. aL\} 01io
Site Plan Name: - Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCIR'IPTI!ON fJF iN®RK.
(, �
•ONSTR�l1CTION IN!FOR++� � Tl0'N:
Additional work to be 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:CC PLID Sq. Ft.of First Floor:
a5
Cost of Construction:$ 0 Utilities: —Sewer _Septic Building Height:
OWNER�LE-�S EE: CONTRACI4R.
Name t Name:
Address: '115, SonaS-e tc'id Company:
City: �t State: -f- Address:
Zip Code:?995 a Fax: City: State:
Phone No. ��a"O� �.1�0`� Zip Code: Fax:
E-Mail: Phone No
Fill in fee simple itle 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.
vgug. MEIU ST +tJCT1UN01 1'EN W I - MA Q646
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.
N
Signature of Owner/Lessee/Contractor as Agent fo %tQr� Signature of Contractor/License Holder
a
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STATE OF FLORID - mom
z STATE OF FLORIDA
COUNTY 1 COUNTY OF
moo
The for oing ins ent was acknowledges before a-W The forgoing instrument was acknowledged before me
this day of 20�7 by M this day of 20_ by
«,Vo
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Name of person making statement. ",",',*;;'' Name of person making statement.
Persona II now OR Produced Identification Personally Known OR Produced Identification
Type of Identificat' n D. Type of Identification
Produced •L Produced
(Signature of Vary Public-State of Fidrida) (Signature of Notary Public-State of Florida)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
re-v-. 8/2/17