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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: / Permit Number: :ECEIVED ` A � 2G�9.Building Permit ApplicatioPlanning and Development Services ST. Lucnty, Permltting '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: P�ED IN2R0VEM1ENT LOCA ISN: Address: /wilt-'a // � Gi�i�l �sG r Til 31 Legal Description: Property Tax ID#: 3��'��� deo Cj�01" d 80 C) Lot No. Site Plan Name: Block No.. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DE�SCR PTION OF WORD C©NSTRUCTItJ CW1.1 Mitina wor to e,pe orme un er t is permit—c,ec a tat appy: echanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ `T'g/S' Utilities: —Sewer —Septic Building Height: OWNER/LE�S�S CONTRACTOR: Name /,c�F.f�fo/ 1,PiZ—S �7/�i Name: D,,/L,64L,,?> .�5 Address: 'I9�61 Company: e�lG�IS/09wr�Q..�,c/e— City: tl State, Address: Zip Code: F��I_5_ Fax: — City: � �� ,N State: Phone No. Zip Code: "",5"2, Fax: E-Mail•_ Phone No Z7-2, ��4 Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License IZA 0o elSG If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. uslutPLEMI!@N CQNST +UCT14 L LAW 'F+ RMA 0 ° 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 commencing work or recording our Notice of Commencement. 'nnag v � t Sign pure of Owner Le ee/Con r ctor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF x'11-- • L-J��e The forgoing instrument was acknowledgM before me The forgoing instrument was acknowledged before me this day of ay '0j 20_ by this \ day of CX J 20 A by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Nota14 Public-State of Flor da t' (Signature of, otaJSP"' F o'tida' 14S pJIAR1E co°e ` 22023 m GG 022023 {li -�:�:.... [��yCOMfdISSION GG Od 0 Commission No. GCza <° MY( rfSS2�mber16,204" 4'1 Commission N� `. T, 'a.�1F°�PI :Decemt,ep IN *= E?CPIR `�D Nblicundenvrie.',I i I ;;.. •o?r Bonded lhru -07-ly ��it, iter.: ?Ond St ru tlotaN REVIEWS FRON "TONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW. REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17