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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COM =i,`'rED FOR APPLICATION TO BE ACCEPTEV - ,Date: Permit Number: Building. Permit Application 2017 Planning and Development Services Building and Code Regulation Division PERMITTI 2300 Virginia Avenue,Fort Pierce FL 34982 St.Lucie o ty,FL Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: %_0 o-%Ir- PROROSED 1NPROVEMENI' L©CATItJ\�N: Address: Legal Description: Lo��Gek�v�oo d- ���-V v"� © � jl��- S/0 Property Tax ID#: t30 (-' 6('2-- 0 0 b ] Lot No. 1� Site Plan Name: Block No. (33 Project Name: ���— Setbacks Front Back: Right Side: Left Side: DETAILED DEQ- GRIPTION 0F WORK: 41- M W 1 -MA ION: Additional work to be pertormed under tis permit-check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters -Windows/Doors _Electric _Plumbing _Sprinklers _Generator Roof Total Sq. Ft of Construction: \ �i000 Sq. Ft.of First Floor: Cost of Construction: $ I q, 062', Utilities: —Sewer Septic Building Height: ODUNER/LESSEE: CONTRAGTC?R: -Name , ' 'y CC- Name: c, . C- ,. -Address: Company �z� ��lo City: State:�L Address: V Zk p 1 � Zip Code: :',It- S( Fax: City: Qi-0 .c9 C State: Phone No. _7 tZ Zip Code: yJ�l 6 Z- Fax: E-Mail: Phone No Fill in fee simple Title Holder on next page (if different E-Mail from the Owner listed above) State or County Licensees y3 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SCJPPLEMENT L CONST UC'NiQLIEN LAW F(?RMATlO.N: 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 com in w rk r recording our Notice.of Commencement. nature caner ssee/Agent Signat o Con or/Lice older STATE OF FLORIDA STATE OF FLORIDA COUNTY OFCOUNTY OFc�l The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this L day of h^' � 2017 by this �— day of MG'Yh 20(7 by "eAl (Name of person acknowledging) (Name of person acknowledging) (Signat re of Notary lic-State of Florida) (Signator o Fi ary Publi ate of Florida) Personally Known l @KM ,iced IdentRkffiiWEZV ersonally Known "d (denti il� �Sr ER :°. ,`� Notary Public-State of Florida ;=a b otary ub is- tate otFtorid Type of Identification _ y Type of Identification n._My Comm.Expires May 18,2018 Produced .�(iL� "; d My Comm.Expires May 18,2018 ProducedL.Q� -9, ,. ommission# FF 086006 ,F oP;� Commission#FF 086006 OF F�° �L ��°A F`� Bonded 1luough National Notary AS . Bon d Tl gh National Notary Assn. —�( 0 6 ,'', " ) Commission No. �$ Commission No. 5 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE / 1 RECEIVED DATE COMPLETED Rev.7/2014