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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLtfED FOR APPLICATION TO BE ACCEPTED Date:I-IQf� \ 'Zn6 2G�� Permit Number: CIO RECEIVED 5 ® "t APR 0 2 2018 BuMi \ gip ermit Application Planning and DevelopmentServices ® N�`��c\0� Perrnitting Departmen St. Lucie County Building and Code Regulation Division- 2300 ) 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: Address: SW-1 PCA\2C) e�ne-S C ! (`C..le, Legal Description: Lo-1- 261 (o UR R 14W dC T��� G� Property Tax ID#: Lot No. 291 Gv Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: I I e- v;��� enc2 2 C�ci�e5: �� ecRc>n z 1 I `�)AP © Xno 05-e - I Additional work to be pertormed un er t i permit-check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _PlumbingC( _Sprinklers _Generator _Roof Pitch k Total Sq. Ft of.Construction: k � . Sq. Ft. of First Floor: I Cost of Construction:$ a�\0 O d Utilities: —Sewer _Septic Building Height: I Name 1-CA�/C� SCvi ne 1 o a Kerne: Address: �J \tJl-� ��A SPC) \���1�5 C10 Company:'; I City: F',•--k e rc C' State:f L, Address: Zip Code: Fax: :City: State: ne No. 2- S2�%'2 -60Z a -Zi p;Cade: Fax: E-Mail: `Y,0 T ks 17 �i�J GO �• CC'VV Phone No' Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) "State br County License I � if value of construction is 2500 or more,a RECORDED Notice of Commencement is required. I ' � 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: I Zip: Phone: Zip: Phone: I OWNER/CONTRACTOR AFFIDVIT:Application is hereby made-to obtain a'permit to do the work and installation as indiciated. 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOLENDER O AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." _URVVV�- S ature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder I STATE OF FLORIDA I n' STATE OF FLORIDA COUNTY OF Biu—�(_� COUNTY OF I The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this C5_day of 20J,� by this day of 20_ by Name of person making statement. Name of person making statement. i Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification- Type of Identification Produced Produced (Signature of Nota (Signature of Notary Public-State of Florida) �l� VB ELLEN VAUGHN Commission No. :r° 4o';State of F(59AJ3}Notary Pub]ic � Commission No. (Seal) 'c ommission # GG 27007 o«,o�,` My Commission Expires October ;eL, REVIEWS FRONT ZONING PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE I COMPLETED ev. I