Loading...
HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:. Permit Number: a 3 tr RECEIVE® - � — Building Permit Application JU,�! 2 0 2019 Planning and Development Services ST. Lucie County, Permitting Building and Code Regulation Division -----_- 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSEDY�IM'PROVEMENT LOCATION: x , Address: mILS L g I scription: (1846-- 6LY,!5(LqAPI II AlV Property Tax ID#: �� -D� '�4 t� Lot No. OW Site Plan Name: J Block No.91 - Project Name: Setbacks Front- Back: I Right Side: Left Side: _ DETAILED DESCRIPTION AOFAWORK A-5 W n►© 6I�% DDO nog D y.COIVSULICT pN. INFORMATION Aclattional work to be ertorme -under is permit check a apply: HVAC ff Gas Tank ❑Gas Piping _Shutters a W indows/Doors IJElectricE Plumbing Sprinklers ❑Generator ❑ Roof Roof pitch Total Sq.Ft of Construction: 14Q 6? S ,Ft.of First Floor: l � Cost of Construction:$ / a' �J Utilities: _Sewer Septic Building Height: / Vl OWNER LESSEE: CONTRACTOR; < . Name �, v/� 11 A Name: J Address: W p U �__ Company: C City: State: ®® Address: r5 Zip Code: Fax: 3 U City State:/:— Phone No. Zip Code: l Fax: 3 E-Mail: -! 4 Phone No. - O Fill in fee simple Title Hol er on next page 1 if different E-Mail: fro the O er listedabove State or County License: 1 If value of construction i 00 or more,a RECORDED Notice of Commencement is required. 75 SiDf SUPPLEMENTAL CONS1 RUCTION,LIEN IA,W INFORMATION. DESIGNER EN INFER• Not Applicable MORTGAGE COMPANY: x Not Applicable Name: Name: Addres Address: City:_ State City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: of 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 commencinp,work.or,recording our Notice of Commence Signature of Owner Signature o Contradp/� orlder STATE OF FLORIDA STATE OF Col COUNTY OF I • LU C"�(E COUNTY OF The or ng instrument acknowledged before me The forgoing instrument was acknowledged before this `ay of �� ;20 by me this % day of AueUst 2018 by -Dr l Y 00 G, C YRD N Tom Saurey Name of person making statement `/ Name of person making statement Personally Known , OR Produced Identification Personally Known xxxx OR Produced Identification Type of Identification Type of Identification Produced, Ems L.,tC;E.IaIS Produced NSA JOHN P.HUNT (Signa re of Notary Pub Vo.:f of OF FWF1I A (Signature f otary Pub-fic to o c� ),Y (-killS3,• Coy �Gttt539 20 7402362 OTARY is cion No Expires 6/5/202'6 Commission No. TE OF C ADO NOTARY ID 20174023626 myrnyigAiqqi0NF;ypigF. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED, DATE COMPLETED