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HomeMy WebLinkAboutBuilding Permit Application ALL,APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:. • ' Permit Number: EC a` loVE Building Permit Application MAR 2 3 2017 Planning and Development Services Building and Code Regulation Division St. Lucie ie ITri4�lG ' 2300 Virginia Avenue,Fort Pierce FL 34982 Count� _ Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line �Oc PROPOSED IMPROVEMENT LOCATION': Address: _10 8'31 5 0 Cea,,j 7•- L_,� Legal Description: 1Vv*W©►'ht!�L_r1► tlrac�? 1):rj *y-g ScA Co,,jAo��,wrug, No ( uAT \_ C A,,I -Qro _Rpka C6"V,►"-,0,:! &-- 1941 IS�ick Property Tax I D#: y S1 1 - R 1®- b 1 t13- 000-1 Lot No. Site Plan Name: Block No. Project-Name: 1 cg-,,A�j Do CtZ W\i y", T10,��.4 Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK vic"t", Doer Cal? r� tic-, CONSTRUCTION INFORMATION: Additional work to be nertormed under t ispermit-c-check a apply: 1]HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors Electric 0 Plumbing []Sprinklers E]Generator Roof Roof pitch Total Sq. Ft of.Construction: S Ft.of First Floor: Cost of Construction:$ �a-a00, Q 0 Utilities:[]Sewer 0Septic Building Height: OWN'ERAESSEE: CONTRACTOR: Name -0 VL ?,,g r rji c5 Name:Address: Company:ll`� � 5. f�.C,��.i 0.�..�� Company: Y %onNklIP� L LQ City: State:jL Address: i Vcy S11,ch"s'k-UjAu Zip Code:' '34ci r1 Fax: City: 6\n,C',1-'/ State:F( Phone No. Zip Code: 3'i q CA Fax: E-Mail: 1r., & A r, cs,!2*tA C cCo Phone No. �)-�JL b i- 4 0S"5' Fill in fee simple Title Holder on next page(if different E-Mail: Tac: tlU�1t r� yr,Nac� C er+n from the Owner listed above) State or County License: 3 GO Z1 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable Name: W,e\tom Name: Address: le`q L% CV A' t I `t - Address: City: State: F% City: State: Zip: `3ycifa.4 Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: �[ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: 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 iwaccordance 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. Signature of Owner/Lessee/Contractor as Agent for Owner Signa ure of Contractor/License Holder STATE OF FLORIDA 5�- L : STATE OF FLORIDA 1 COUNTY OF ac 'e COUNTY OF L The forgoing instrument was acknowledged before me The forgoing instrument wa acknowledged before me this ay of Ye 1/� 20 aby this day of 20 by 1 �� ►a U �v i a. R�r }fir (Name of person acknowledging:) (Name of person acknowledging) 4 Nut ,, r , _-.A,-'�" % . �' . - CT, (Signature of Notary Pub ic-State of Florida) (Signature of Notary Public-State of Florida) Personally Known L OR Produced identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced I 1 V•!— Commission No. r— r q% 3a)(Seal) Commission No. I AREN S. NIELSE Commission # FF 115 + .. CAROL A.PREW June 12, 2018 Revised 07/15/20�14 � Notary Public,State of Rodde Commission#FF 14 Q� y Comm,e 11 , fires Aug.10,418 REVIEWS FRONT ZONIN VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE �I��L ` a•� • INITIALS J