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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: I �/� Permit Number: Building Permit Application OCT 2 6 2017 Planning and Development Services PER�/iITTING Building and Code Regulation Division St. Lucie Cou , FL 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of lin 4 P}ZOPOSEDIMPROVE(VI`ENl"L®CATION Address: L__r )►U1 `I`'iI�'�n-I`L�C�. Legal Description: u �e Property Tax ID #: Site Plan Name: Project Name: _ Setbacks Front L4- �5 Or ) 034--- I� _gp1_C)— O-q Back: Right Side: Left Side: Lot No. Block No. Electric 0 Plumbing Sprinklers 11 Generator Roof Roof pitch Total Sq. Ft of Construction: Scl. Ft. of First Floor: Cost of Construction: $ 2 9!2�C ©m Utilities:El SewerEl Septic Building Height: Name Name: S Address: " m meadao" M. Company: //11 City: ` ' _ l� Stae: Address: /�� Zip Code: L 5 Fax• J �0` City: I— I ctata f�% ' Phone No ,n +Y=Wo! de: � ( Fa,��7'�- 3J ' E-Mail: I IR— i F1 I ' 7 — 18� — 0 Fill in fee simple itle Holder on next page ( if different E-Mail: o+ 11( from the Owner listed above) State or County L tense: If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. .0 SUP, PLEMENF,T�ALZONSTR 9fit ,-v 6.- h7 t }4YY 7-IO:N;. O irT ONYLIEN - 4A,7 la �Ag,T4 �&t1 LAUU INF®RM" T7 DESIGNER/ENGINEER: Not Applicable Name: MORTGAGE COMPANY: Name: _ Not Applicable Address: Address: City: State: Zip: Phone City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: BONDING COMPANY: Name: Not Applicable Address: City: 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 commencing­wcI or recording our Notice of Commencement. Signature df Owner Lessee/Contractor as Agent for Owner Signature cf Contractor/Licens older STATE OF FLORID 1 C' t STATE OF COUNTY OF ORIDA<L J u C1 e J� l� COUNTY OF The forgoing instr=ent was acknowledge before me this Q day of OCt 20 by The*going instrument was acknowledg�efore me thisL-P day of CJ 20 by Name of person ing statement Name of person_ ing statement Personally Known OR Produced Identification Personally Known J OR Produced Identification Type of Identification Type of Identification Produced Produced r WCV� 00A i ✓U-� 111 U�1 (Signature of Notary P blic- State of Florida) (Signature of Notaryublic- State of Florida ) Commission No. (Seal) mission No. (Seal) APON NICHOLE APONTE . , .,, N�MOLe 3E03� . REVIEWS FRONT �� SAY OM �. ZD S VEGETATI .4!. .A TI LES �VJE COUNTER REVIEW REVIEW Moir ry LVV DATE ` RECEIVED DATE COMPLETED Rev. 8/2/17