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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE CO!.ETED FOR APPLICATION TO BE ACCEPTI ` y 2i�(� Date:. I-1 (� Permit Number: i 10� 03C I REC44V® Building Permit Application JUL 17 2017 Planning and Development Services Building and Code Regulation Division PERMITTING 2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County, FL Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential _/ PERMIT APPLICATION FOR: Renovation .PROPOSED IMPROVEMENT LOCATION:` Property Tax ID #: 333 4 - .5os - W4 (o' 000 -'T Lot No. Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: Block No. Repla��, k��ctnen C�xlSt-ling -t ao��n nt) fiY OL03 damC ot& ftt oiom ar-tA Npkacc bathroom von Lbes- due fa Flood.. W t'�i OASO pu-ttin MW -look +i1e Ina ii- ehang Inq out 11 hiinq RkWt es Urcl Nddkng -��4 1'�euv Ii h i gg X�-urns -tha C 2 ��e; k.,-0� ran + 2 IV) 1 e gUes� 1x�.th J See a4aChed SCOX MCC FOr RM I (16td I IS CONSTRUCTION INFORMATION: Additional work to e e orme un er t is permit - check a apply: ❑HVAC 11 Gas Tank as Piping Shutters Windows/Doors UElectric © Plumbing 1sprinklers 0-Generator F] Roof Roof pitch Total Sq. Ft of Construction: 11� �Ii S . Ft. of First Floor: Cost of Construction: $ y 5 i 0�� UtilitiesSewer Septic Building Height: OWN ER/LESSEE: CONTRACTOR: Name Gf-imit1 kyytVi Name: Address:_ N D ChaW g) (M c, \N(D�j Company: City: i706 a. Lwk State: F Address: Zip Code: 3yg?)(o Fax: City: State: Phone No. 9 ' C.- h`1 i (0 Zip Code: Fax: E-Mail: t Phone No. Fill in fee simple nle Holder on next page (if different E-Mail: from the Owner listed above) State or County License: If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRU LIEN LAW INFORMATION: 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: jNot 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 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 commenciaR work or recording vour Notice of Commencement. Signature of Owner/Xessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF %111J,L. The forgoing instru ent was acknowledged before me this I—) day of 20 1`Iby l \ (Name of person acknowledging) (Signature of Notary Public- State f Florida ) Personally Known OR Produced Identification Type of Identification Produced 'n'lu�ek� ss�o • a�sO�s • �c�3 Commission nNo. (Seal) S Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OF The forgoing instrument was acknowledged before me this day of 20 by (Name of person acknowledging) (Signature of Notary Public- State of Florida ) Personally Known OR Produced Identification Type of Identification Produced Commission No. (Seal) r— H���1 State of F onu6 %a Notary Public 2p18 Revised 07/15/2014>� Expires Dec 2 Comm. =DAY mm�ssion # FF 17724s A"n ��MOM e or f4 , R ed through—'r� VISOR REVIEWS FR©N�'''���� "' _ZO,(S�IVG SCOPE PLANS VEGETATION SEA TURTLE MANGROVE COUNT "REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS `ll'1M OUL4