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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED in Date: Permit Number: RECEIVED �.1 p Building Permit Application NOV 06 2019 Pllanning and Development Services Permitting Depa rtment Building and Code Regulation Division St. Lucie county 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PIERMIT APPLICATION FOR: &, e �? Adl ress: 31t Legal Description- U✓�1-6�a �it/S CAD �C�rs-3 lOT a 2 -78 11 Property Tax ID Ole 2, - C)d!�0 - Lot No. f Site Plan Name: Block No. "-_�/ Project Name: Setbacks Front Back: Right Side: Left Side: �n©vc_ 4- Tota I Sq-.' i ai-worKLo De perrormea unaer haneal _ Gas Tank _ Plumbing - cnecK a Gas Piping _,Sprinklers (iinstruction: ction: $ _ -Strutters t r�s-,'Generator Sq. FC-of First°,Floor: _ Utilities: /,�l ANy flLb�e7%f (,,�u1S Name; !�V 4/0/" Como. -ity: 'OL%, r l e;A G ie State: r �- Zip Code: —9-CI9 SD Fax: phone No. -Mail: '111 in fee simple Title Holder on next page (if different from the Owner listed above) _ Windows/Doors VX Roof Pitch -Septic Building Height: Ili; Address: D Lf�iTl� City: `'% i�/L�G State: Zip Code: 2 PJ_Z� Fax: Phone No 72 + 2-0g E-Mail *VD/Los 0-0A1S1 " d-%/OJL/ ,9=iL , C� State or County License O�7C- value of construction is 2500 or more, a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: Name:_ Address: City: Zip: Phone Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: State: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: Address: City: State: Zip: Phone: BONDING COMPANY Name:_ Address: City:_ Zip: Phone: Not Applicable 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 iprysspection. If you intend to obtain financing, consult with lender or an attorney before commencing w tk or recording vour Notice of Commencement. , Signat re f Owner/ Lessee/Contractor s Agent for Owner Sig . a ure of Contractor/License Holder STATE OF FLORID�-, / STATE OF FLORIDA / _ r OF COUNTY OF Jif - _I`_ COUNTY The forgoing instruimpent was pcknowledged before me this J day of deb 202�by The f rgoing instru ent was cknowledged before me this V day of v 20J? by- u N'u 1t t- 1-toud co7 O Gt( 7F (Name of 6erson acknowledging) �n1 (Name of erson acknowledging*ka.. ) ca (Signature of Notary.Public- State of Florida �. � � / N f�t Personally Known V_ OR Produced Ide140 (Signature of Notary Public- State of Florida) y Personally Known OR Produced Ide i.. t Type of Identification '� CO2 Produced X N Type of Identification Produced Commission No. ���7 � 3� S�� ( pm Commission No. � AST. S I REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 7/2014