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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED a�,� J' Date: )�- Permit Number- �'�U-�� c)44 (O. 4 E iii iiiii ill!',I 11111 111,11 L gt - MAR 7 2020 Building Permit Applic tion Planning and Development Services pE r f 31 Cif i } '-;G E) rtl�� Building and Code Regulation Division St. Luc q Urlt��, FL 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: PRGt;P�SED I, Rt!}iViEMI?NT L �r IIUI� NP, Address: Legal Description: -7:S q 2 Property Tax ID#: Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side:. Left Side: D`ETACL © DE�SCR+IPT ON fJF ORK: rr� CIO e2 V-D:kZW 49 CONSTR�U TI.O INFQ ' MATION: Additional wor to be pertormed uncler this permit—check all that appy: _Mechanical _Gas'Tank _Gas Piping _Shutters �ndows/Doors Electric —Plumbing —Sprinklers —Generator —Roof Pitch Total Sq. Ft of Construction: z(ri/r�, Sq. Ft.of First Floor: Cost of Construction: $ Utilities: —Sewer —Septic Building Height: OW ER/LE�SSExE: � CtJNTRA OR� , Name C2 �` <„ " .._ - Nam' . Address: i � , ;.�n ,`2. Company .. i f J i •.4,� City:�i1 r� S \(elfl �' State: Address V C� r Zip Code: �2` " Fax. �,r } City: SC v State: , Phone Nom 22 i —,� " � / Zip Code:3C/Cf 3-� Fa E-Mail: Phone No Fill in fee simple Title Holder on next page(if different E-Mail r from the Owner listed above) State or County License o2-0 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SIJp'P.OlEgMENT ry L C�NSTRUCTI�N LIE7N LAIN I,'NFCIR.MATlN: 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. S4 . 14AX4 Signat re of Owner/Lessee/ ontractor as Agent for Owner Signature f Contractor/License Holder STAT OF FLORIDA STATE F FLORIDA COUN F COUN Y O The forgoing instrument was acknowledged before me The forgoin 'strurdtwas acknowledged before me this l7day of !Z , /_'& 2Q.>V by this-LZ day of Mner 20>V'by (Name of person acknowledging) (Name of person acknowledging) (Signature of ary Public-State of orid (Signature of tary Public-State o Florida Personally Kpown OR Produced Identification / Personal[ own OR Produced Identification Type of Iden ific t n Type of I enti cation Produced Produced . AUDREY 8.HUMPHR 00 AUDREY B•HUMPHREY Commission No :' ,YP` •••. COMMIS M�G3�S17 Commissi Y° issl #GG3WA1) March 6,2023 *: :*_. EXP S:March 6,2023 r 0_0' xNptBfyPubl'�CUndelWf rs s p: {REo Publicundo*r tees REVIEWS k0w_N_T'� ZONING SUPERVISOR PLANS EGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 7/2014