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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUSTT BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: f �� • Permit Number: �� a RE"El'" vED ' JAN 282019 Building Permit ApplicaLR Planning and Development Services ing Department Building and Code Regulation Division cie my FL2300 Virginia Avenue, Fort Pierce FL 34982 rPhone: (772)462-1553 Fax: (772)462-1578 Commercial Re PERMIT APPLICATION FOR: PROPOSED INPR,OUE ENT�OCATIt3`N: Address: 4!0LEW c)94 CGgcLtf- Legal Description: 01-Z5' —702- — 0/ 3G 000 Property Tax ID#: Lot No. Site Plan Name: Block No. 1t� Project Name: Setbacks Front Back: Right Side: Left Side: DETAILEQ DEvSCRiPTION OF W©RK. low n 09L/elm ULM CQ`NSTRUCTLON. 1NNl R Additional work to be pertorme.d under this permit-check all that app y: —Me anical —Gas Tank —Gas Piping —Shutters _Windows/Doors ,v — umg p Electric Plumbing Sprinklers Generator. Roof Pitch — — — — Total Sq. Ft of Construction:. 700 00 Sq. Ft. of First Floor: Cost of Construction: $ Utilities: —Sewer _Septic Building Height: OWNER/LE=�S� �� CONTRACTOR; Name 5 ` w Name: S crl6T Address:: Company: vu/V City: L(JGt C State: . Address: Z'(I zo r—UC L' Zip Code: 52- Fax: City: �- 1EW-10-c- State:EA Phone No. U 2 — Zld 2-7 Zip Code: 3�`z �/ Fax: E-Mail: Phone No 2 �3 5 Fill in fee simple Title Holder on next page( if different E-Mail �� 2CT -LC -�/yl from the Owner listed above) State or County License O d If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL C�NSTRUC«1`I®N II'lRNA LAW INF�JRMATION: 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�� comm 'n r or recording our Notice of Commence t. (ZWW' , � f L��L��Sign ture f wner/Lessee/Contractor as Agent fo - t=ln Si at re of Contractor/License Holder a o x" , S ATE F FLORIDA ATE OF FLORID 2 m M C TY OF X< COUNTY )I • 2 7JS� c c,2C The forgoing ins ent was acknowledged befor ink m The f r ng instr e t was acknowledged before PL8" mT this day of 20f� by z this day of 20�by Sa h n � ovm �h Name of person making statement. N Name of person making statement. J Personally Known OR Produced Identifica io Personally Known OR Produced Identification Type of Iden ' ti Type of Idemtifis t'on n• Produced lr' Produced kVi L , (Signature of No ry Public-State of Flori V (Signature of No 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 Rev. 8/2/17