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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETD FOR APPLICATION TO BE ACCEPTED Date: Permit Number: RIECEW D Building Permit Application- NOV 0 6 2017 Planning and Development Services PER"tlTTING Building and Code Regulation Division St. Lucie County, FL 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: kz!co F- W � l Address: 16 !c) Legal Description: V6Z1\iDp s Property Tax ID #: 114 g 54 r7FM — ft Q !'— 0 NO' Lot No._ EJ Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: Mechanical _ Gas Tank — Gas Piping :: Shutters Electric —Plumbing —Sprinklers Generator Total Sq. Ft'of, Construction: 1 ��� (�I J Sq. Ft.:of First Floor: Cost of Construction: $ 3 p Utilities: _.Sewer _ Septic Wi Roof )wslluoors 3/ A Pitch Building Height: 4W'NER/L.EwSSEE: �®NTRACT©'R; Name Address: i D,1 - %N Au c City:P.State: ' Zip Code: ; 4c!'t� t' Fax: Phone No. (��) r S �' � 'r Name: Company:'' Address: -`'r�n�� LC �,-..�-,-r�U L city: 270E Zip Code: I Phone No L-77a o�T14N, Atlantic Ave. State: Fax: E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-MailUdGad 1 State or County License n 1 �` If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SAM"P :EfVIENT6, t, CDN�TRfJCTIt N Lf,EN W t F�RM,ai'fON DESIGNER/ENGINEER: _ Not Applicable Name: Address: A City: State: Zip: Phone MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: I FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: 4 `1 A— Address: I City: I Zip: Phone: I I BONDING COMPANY: _Not Applicable Name: n 1 ,., a Address: City: Zip: Phone: ' OWNER/ CONTRACTOR AFFIDVIT: Application is here by:made to obtain a permit told o 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 gralnting 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 Reco fd 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 a first ' spection. If yo intend tolobtain financing, cons It with ender or an attorn. y before comm tncing k or�ecordir your Notice of Commencement.% � %P . , i Si wner%.Lessee/Contractor Agent for Owner, Sign;re of Contra cto r/Licens Holder l ST E OF FLORIDA STATE OF FLORIDPA I COUNTY OF o i COUNTY OF i C.l'L���(. The Ilay instrum nt was a knowI dgg efore me The fo mg instrumen was acknowledge{�ef this of 20 17by . this day of 20 f l; b p �1 tidys NOr l tj o \1A (Name of person acknowledging) (Name of person acknowledging) 0 R. (Sighature of Notary Public- State of Floridz (Sig a re of Notary Public- State of Florida) P Known OR Produced IdentificType OR Produced ILntiff t�o►� , Wally L&I `.grcnnall_Known of Identification _v2 K -'' Type of L en ionProduced Produced Commission No. Commission No. 1� � (Seal). - REVIEWS FRONT .''ZONING�i SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED