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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO /MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: of j"/ /Gi' Permit Num ... ; i. M 1 , 000 FEB 1 201 - - Building Permit Appli ation. department Planning and Development Services Permitting Building and Code Regulation Division St. Lucie County, FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: PROPOSED IN�PR{�?UEMENT L.00ATI Address: 26 �Ay Legal Description: Property Tax ID#: �� 000S 000 ( Lot No. S Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: QETA)LED DE���RIPTION QF WOR -. CON5TRlJCTI,� I!N�FOR ATION: Additional work to be.performed under t is permit-c ec a tat appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electriclumbing _Sprinklers _Generator _Roof - Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ ��� �1 Utilities: —Sewer —Septic Building Height: OWNER/LE�-S�SEE: CONTRAST R•, e G�,_. Name � ' �"� Name: o u' �v�� 1J Address: 2-bo1 L' Company: 1-- City: to H•�'� C-,I State:Dt Address: 1'71 J s w ` Cn Zip Code:, Fax: City: iz/ C State: . - Phone No. Zip Code: I `( F L( Fax: E-Mail: Phone No __�7 'L 3-) 0 f /J_V 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. SUPPLEMENTr CONST( U�TI©N LIEN LAW 1`NiFgRMATIC�'� 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,sw7imindpools,fences,walls,signs,screen rooms and accessory uses to another non-residential use WARNING TO OW,NER.,Your failure to Record a Notice of Commencement may result in your paying tw..' improvements tpyour property. A Notice of Commencement must be recor d and'aosted on th 'obsit before the first nspe�cti fi. If you intend to obtain financing, consult with I der r.,an attorney be qr w^.o commencingfiiork or r cordis our Notice of Commencement. ,f rN f rL LL. Ci' ff =CL at cb Signature f Owner/Lessee/Contractor as Agent (# Signature Contractor/License Holder 04 1 LL.N STATE OF FLORIDA STA OF FLORID COUNTY OF COUNTY OF Lu� c.0 The fo��gaoing instru was acknowledged befo �a FE The forgoing instrum t was acknowledged bef r-q;�e' ` this. i-day of rPi� - 204 by ¢gw this /O day of 20/-1 b " Name of person making statement. =g.. F., Name of person making statement. h*„fit• / Personally Known OR Produced IdentificaLlUll Personally Known ,, OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of ary Public-State of Florida) (Signature of No Public-State of Florid ) 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 Te—v. 7