Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Q � Permit Number: 1ey 1 RECEIVED MR ., W.� Building Permit Applicati n JAN• 17 2019 Planning and Development Services ST. Lucie County, Permitting Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 _Jz Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: P 0141 'OSEO ! ROVEMEN LO ATtO ° Address: 1. G v ierd e f 5^t', 9 Legal Description: Property Tax ID#: ' \ ' 'SO L—' C 6(CIO• QlJ'l.i '3 Lot No.�� Site Plan Name: Block No.- Project o:Project Name: Setbacks Front Back:. Right Side: Left Side: DET FLED DE=S�R'IPT'ION O WORK: Q ,��g. I 1� ia 11 CO STRUCTI'O �NFORNI� TION: Additional wor to be pertormed under this permit—check all tat appy: _Mechanical _Gas Tank _Gas Piping —Shutters _Windows/D6ors Electric _Plumbing _Sprinklers _Generator _Roof �lvl Pitch Total Sq. Ft of Construction: v 0 S Sq. Ft.of First Floor: Cost of Construction:$. �.�00, 00 Utilities: —Sewer _Septic Building Height: OWN =R/LE�S� �E: CO TRACTOR: Name_ jj L9 Mbr.9 Name: :, Address1 T 0J: ,6 (e' Company: City: 1 State:_ Address: Zip code: 3419 Fax: City: State: Phone No. . Y —973 —.1687 Zip Code: Fax: E-Mail: O m br / 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. UPPLEMENTAL CONST 11CTl©N lid LAW IN`' RMATfO 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 thepermit 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. Signature of 11 Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The for ing instrun ent was acknowledge before me The forgoing instrument was acknowledged before me this day of 20L`I by this day of_ .20_ by �1i�1F� CYI Fn Name of per§bn making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identificatio Type of Identification Produced Produced nature of Nota P - e o ar S. NIELSEN (Signature of Notary Public-State of Florida) (Sig ry iPPY PV i _ `=o 5tate of Florida-Notary Public Commission No. c comr�ypin # GG 207484 Commission No. (Seal) +� o My om fission Expires June 12, 2022 REVIEWS FRONT ZONING =::;;i,.SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED :Fev­. 8/2/17