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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST'BE COMPLETED FOR APPLICATION TO BE ACCEPTED d Date:�� l Z '��l Permit Number.: RECELVED Building Permit. Appli do P 2 2019 Planning and Development Services 5t. Lucie Coun Building and Code Regulation Division ty, Permi g 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772).462-1578 Commercial Residential PERMIT APPLICATION FOR: Q . 40 PROPOSED IN'PROVEME T LOCA 10" Address:.. �o I''�--11 /, �Leal Descriptio a .'3 1) IAJ /`� rD� "�. j �S �� ! 1� D E -S ((� "Z6S:S' . P(-ID CALAL AIQ l 0 Or FA-GG &101 k SSS -J)A7((7-14, 16 e 60►a1'7 P. 3 Property Tax ID#: 141.2 —310 019 0© '' Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: D T ILED DESCRIPTION OF WORK: C/nov� r CONSTRUCTION III=ATION: itiona work to be pertormed under this permit—check all that appy: _Mechanical Gas—Tank, • - Gbs-Piping _Shutters Windows/Doors <. Electric _Plumbing Sprinklers _Generator ✓ Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction: $ 4y Utilities: ,,Sewer _Septic Building Height: 01111NER/LE=•S�SEE: 1ONTR C 0 Name _ FJ� .Dpyv Address: :SJ�' ✓� Company`,' U PSS.. 1 I D!� L f; City: 2 /� "�� :< State:/' Qcidress d;� '/e, / Zip Codes /� FaxiJ ' i,' City:- State:Y Phone Nozei� .3�a Zip Code 7.!-r'' Fax: E-Mail•• ULV94Z.TA ! rJO,�L!�qWN1m Phone No Fill in fee simple Title Holder on next page(if different E-M a,ij& 49S ZCP�S)X/ erCO� 01/✓?el from the Owner listed above) State or County License l�p�C,C 112 `✓::� If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. S1JP�l,EMENT .L C®NSTRIJ.�T10 LIEN LAW 1`N -QR!MATIC? 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 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 commencing rk oy//ecording your Notice of Commencement. Al Si nature of i/Les ee/Co ractor as ent for Owner S g e f C tractor/License oder STATE O FLORA STATE OF FLORIDA COUNTY OF ss �-9c�� COUNTY OF 5 k_ L%ar_� The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this\ day of 2011_ by this A Q,. day of S •f 20A by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary P lic-State of Florida) (Signature of Notary blit-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced educed �- M '. IE a�. DEAN #GG NS S10N Commission No.(sem c_�a- --d�.'� pnpR1EG�0�20 3Co ' mission No. `•.• MYCAMM� t3,2�� EpS1t1A N#G 0 - •• _ �(P��S' ppblic�3nda ' <. D OMM\Sg10 2� 1e * Q' ded�'^►N°tat1 •''+.. t�C •0� Vad° � ,y �°;;j...moo• �^ REVIEWS FRONTQ0 OR PLANS VEGETAT ' N SEATURTLE MANGROVE COUNTER •fie REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 7/2014