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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ©�" Q 3� Date: 0-7—"'0 Permit Number: RECEIVED Building Permit Application MAR 0 9 �'190 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 I/ PERMIT APPLICATION FOR: ///r✓ I ROPOSEI !N"RROVEhJI?ENT LO A ION: Address: N e. las RJlITeMS2v� 1J .e.�, F-L-- 3LOSJ Legal Description: Property Tax ID#: yrris�a- Lot No. Site Plan Name:!g'Ale s . °� Block No. Project Name: Setbacks Front Back: Right Side: Left Side: BfTAILEe BRCRIPTlON OF WORK: � C✓ e �' 1- sW h r � c 4,10 1'`1, VOL,7F7 I ALI R C- �fj J1. V�' C©NSTRUCTI©N I�NFORMATlON: Additional work to be performed under tis permit='check all that appy: V Mechanical -�_Gas',Unk . I `` Gas Piping _Shutters Windows/Odors , _Electric _Plumbing _Sprinklers _Generator Roof Pitch Total Sq.-Ft of Construction: r Sq. Ft. of First'Floor:,, Cost of Construction: $ a3S�p Utilities: —Sewer _Septic Building Height: OW, B•/LE-S ff CONT° ACTOR: Name Address:." a 1�1�' �P S =Q vc� E i Company: O� 5, ,1'°l�A`�� i, TA C- city: State: FL Addres5:1'4:� sv,/, Zip Code: `3�l°IJ`� Fax: N' City: C v� ...�.1�Ct :,-_:_.._:.__:._.;: state: FL- Phone No. Zip���°, Zip Code: Fax:JV Il4 E-Mail: Phone Nogq '�Fa-q-jg1&(S% Fill in fee simple Title Holder on next page(if different E-Mail '(�LIOIn�d5 2T" C�1v�nCs1S o 11k� from the Owner listed above) State or County License CG�S 14584 Evalue of construction is 2500 or more,a RECORDED Notice of Commencement is required. S F'Pl.EMEN AL CONSTR+IJCTI.QN 1116N'INNWE ION: 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 mayresthct 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 ma�"'result in your V-4ain twice for Y Y .ppayg 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. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA. STATE OF FLORIDA COUNTY OF COUNTY OF The going instrument wa acknowledged before me The f going instrument s acknowledged before me this day of 20W)by this T day of 20 by --Pup Le A (Name of erson acknowledging) (Name of l5erson acknowledging) (Signature of Notary Public-State of Florida ) (Signature of Notary Public-State of, lorida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identific ' Type of Identifica ' n Produced Produced lkeuRFN S. NIELSEN a��1_State of Florida-Notary Public `o��YPOBa, KAREf S ��IIIELSEN Commission No. _� vE Commissq@r� I�G 207484 Commission No. A; !=State of Fl � r� ,, p,. My CortS i i n Expires _. _ otary Public .,eoff�o .� vc Commission # GG 207484 'nn June 12, 2022 Of f���� MY Corrimissio u_. e?2, 022 REVIEWS FRONT R PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.