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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Lac MAY 0 8 2017 Building Permit Application PERMITTING Planning and Development Services St. Lucie County, FL Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: $\qA a i Address: 9 3 3 o I fZc-A5 U f4c e O a s% .S / . E.. Pie 2G� Legal Description: PALM �P- ELCS CLUB [/ d q4-3 2) QLK 4 Lo i 3 Property Tax ID#: 02,3 d ' J�--t�©- C9 1 :5 9 - DOD Lot No. .3 Site Plan Name: Block No.9 Project Name: Setbacks Front Z O ' Back: Z S .• Right Side: 21 ' Left Side: / F6 17 0 ve �2 �fi�2Cl �O�r2ET� �Ri�d 1�t/��c� D �1'8 -eosEgS l2rRaie y"�PeeP egL?r —3,aoc) • Add itiona wor to a pe orme under this permit—check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: o�yU Sq. Ft.of First Floor: Cost of Construction:$ /, 7496 Utilities: _Sewer _Septic Building Height: Name /\oQC'e i �f Name: CIOJ/ry ifoq)t Address: g,33o T2EElsvec' CD,9s 51_ Company: D65 1 C n/ L.,DY'ICQt Tt City: iT. P'" c- - State: ocf(- Address: 1-(0 ►���L�!'C �REcn� �2. Zip Code: —?c-1983 Fax: City: ipQT Si, LvCic State: C-L Phone No. 7 7 2 - S 82 - -:0 9-T j Zip Code: 3r/!�tg Fax: E-Mail: Phone No ??,I- Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) . State or County License 0 ql 7P If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. :lV e 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. Inconsideration 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. '� C Si ure of Owner/Lessee/Contractor as Agent for Owner 7TATE6COF aof Contractor/License Holder STATE OF FLORIDA FLORIDA ` COUNTY OF � Lv C COUNTY OF Lo The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me this V day of 20-a by this �Z day of 20 by COOL (Name of person ac nowle ing) (Name of person ack wledging) (Sna re of Nota Public- to of Florida) (Sig t re of Nota Public-S e of Florida) Pets ally Known OR Produced Identification Per on Ily Known OR Producg ,41entificJasonHer ion Type of Identification ����,� ��,, f Identification : @•• !%;s''% Y Produced 'FL— @ ; Jason en cited ��' �`'= COMMISSION +f FF 9 �0 �/' _ _ COMMISSION # 1 229 =re C i = EXPIRES:February 019 Commission No. I)EXPIRES:February 2 , mission No�T ! ' flal)yyyyW,AARONNOTA OM <%�r O.... WWW.AARONNOTA 'L'>YdA nnun��� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.7/2014