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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE CL...V�''LETED FOR APPLICATION TO BE ACCEP'i cvf' a # 1 /� 1.� Date: ��• �• �� S\1� Permit Number:- 1 1 l' OC 1 RECEIVE Building Permit Application NOV 0 4 N19 Planning and Development Services Building and Code Regulation Division ST. Lucie -County, Permitting 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: Address: 119I©0 •� �/i.S� Legal De� p i n: #g6 cw_5 Commercial t Residential All)Rr _�T 14 S'F 2 pl—' -S b t ig T,j)AI �1o r�r . Y0 T.S Property Tax ID #:.3410 Site Plan Name: S'T - Z L/e, G iy,- Proiect Name: Setbacks Front Back: Right Side: Left Side: EGG i GCB©� C UT rn 1P.d 14F A( & C'o Lot No. �- Block No. Haaitionai worK to tie perrormea unaer finis permii.—.cnecK aii inai apply: _Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors Electric _ Plumbing / _Sprinklers _Generator Roof Pitch Total Sq. Ft of Construction: //lay Sq. Ft. of First Floor: Cost of Construction: $ �� �00 - Utilities: _Sewer _,Septic Building Height: Narn6 (% --/Qo 4. Name : , • �a, nJ i u Company: Address. ; : (� City`a;t ii �" fie � State: �L Address: A9 �Ztll / °� City: �% I,Fi/��� State: Zip Code: � C/ Fax: Phone No. Zip Code: 244 / 2 Fax: Phone No %7Z " Z/ ' Y%ls' E-Mail: Fill in fee simple Title Holder on next page ( if different E-Mail /1®SC�/✓S�Fvc�wn� (�CA)61 from the Owner listed above) State or County License If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. IM ' �a ii P4 Rf RUM m •r 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 ° comrrAencing,work or recording our Notice of Commencement. gn u O ner/ Lessee/Contracto as Agent for Owner i n ure of Contractor/License Ho er S ATE OF FLORI 1 COUNTY OF Lo,�, e— STATE OF FLO DA COUNTY OF L The f r oing instr men w s acknowledged before me this day of 20� by The f r ing instrumeJ;aga owledged before me this' day of 20J by V fit ��9 t—1 0 AJS ' ro.-� (Name of person acknowledging) (Name of fierson acknowledging) 1 re of Notary Public- State of Florida) (Si ure of Notary Public- State of Florida ) Personally Kno dWl n Type of (dent' t' t�MMISS" # GG� IM Personally Known OR Produced jdentifi at*�o��; Type of Identification `�ernqua . I�iI11u1S _ Produced �+� ?� 9� 2022 Commission No: �� 1I '. Produced r Ic AMU, a ION 0GGSW Commission No. NKM II . 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW, REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. -