HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number.Q6 9 0 3L2,
f RECEIVED
Building Permit Application FEB 19 2019
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2301)Virginia Avenue,Fort Pierce FL 34982
Phoney(772)462-1553 Fbx:(772)462-1578 Commercial Residentiail
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line MIC
Address: 729
Legal Description; dL
Property Tax ID#: Lot No.
Site Plan Name*no Pao _ Block No.
Project Name U
Setbacks Front Back: Right Side: Left Side:
.. fl
l sEu- -7 KR) h a
i i a work toa orme under s permit—checka appy;
MVAC -- Gas Tank DCas Piping �.Shutters 11Windows/Doors
11 Electric I._I Plumbing U Sprinklers OGenerator Roof Roof pitch
Total Sq.Ft of Construction: p� S Ft.of First Floor: _
Cost of Construction:$ �c )Li = Utilitles:11 Sewer OSeptic Building Height:
"Name Name: K' lrY2Grr7
Address- '7-ZQJ k, Company: `
. r
City: + State- Addre r
Zip Code:' Fax:`7 129 -��72"7 City: / t State:
Phone No. Zip Code: ! Fax,`��� ""%��
E-Mall Phone No,� r 7'Z�5
Fill in fee simple Title Holder on next page(if different E-Mail: 5511W,n ac 'coqu
from the Owner listed above) State or C unty License:
if value of construction is$2500 or more,a RECORDED Notice of Commencement Is required.
DESIGNER ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name;__ Name;
Address: Address:
City: _ State: City: State.
zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: -W , 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 Coun makes no represenr�t tion that 1s 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 wort(
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 paong 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
commencin ork or t-ecording your Notice of Commencement.
Sign er Lessee/Contractor as Agent for Owner si f contractor/License Holder
ST IF FLORIyi4TE OF FLORID
C NTY OF _�/vl LI l�L'. ---. COUNTY QF
The Nr oing instr m nt was acknowledged before me The for oing instru nt was acknowledged before me
this .!�day of 20A1 by this�day of frj2rU 20J�by
Name of perso making statement Name of person eking statement
Personally Known_OR Produced identification Personally Known VOR Produced identification
Type of Identification Type of Identification
Produced Produced
CRAIQ A.SRO SMAN _ CRAIG A.QR R MAN
�, -� •�, �Iv coMMlssloly �r-MO2 , �. _ MY OOMMM ON#EXPIRES May I o
(Signature of Notary Public-State. �; poe gnatu a of Notary Public-State 1 '
FrtpNW m
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