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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: "Permit Number: 1 / 7 � AN Fo Building Permit Applicationper7,tt, 1�zo1 St n 9 Planning and Development Services <�ne0epa Building and Code Regulation Division oOuo''y Qat 2300 Virginia,Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: IFIRM04 !N R01/E� ENT LOCATI Address: 51 t7 L nl��tG.n(j Legal Description: -eS,��t Pri pertyTax IfD#: 130 k Ip 6—:IQ0C) A 0b C-3V Lot No. Site Plan Name: Block No. Pri ject Name: Setbacks Front Back: Right Side: ; Left Side: DST lLED DESS�R 130.N' ®F WORK; % i CONE,5.0R, Cl !NF©RR/IATION: Additional work to be pertormed under this permit—check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors . Electric _Plumbing _Sprinklers _Generator ZRoof Pitch. J Total Sq. Ft of;Construction: Sq. Ft.of First Floor: cost of Construction: $ 3rd C�- O0 Utilities: —Sewer —Septic Building Height: O NE f MORE CONTRA Q Name _�hc 7-e�rzrUF A' Name: Address: �S 10 L�lLc 4CUnci Q�vcl' Company: City: �--A AOi<ctr ' State: Address: Zip Code: `_�goJSk Fax: City: State: Phone No. AD- GL3. Gl 4-4 Zip Code: Fax: E-Mail: Phone 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. 11 S tUIE [� NS- I U 11 ,, LAW, � � RIVI �T '_. 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 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. 0 O O Signatur o Owner/ ssee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF n COUNTY OF The forgoing instru ent was acknowledged before me The forgoing instrument was acknowledged before me this�day of nr\_ 2019 by this day of 20_ by Name of a son aking statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced Pro ature of Notary Public-Skate 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 ev.