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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE C6MPLE i tu'FOR APPLICATION TO BE ACCEPTED Date: �o�' I �I Permit Number: NOV 2 7 2017 Building Permit Application PEWAITTING Planning and Development Services St. Lucie County, FL Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Commercial Residential Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: PRQPQSEaD I'�PR01lEMiE LQCATIa Address: I C) r-1 Legal Description �� /Mk m 1 ) �P4�S S I 3 _ ��%� � t0 Property Tax ID #: �� 1 D I" C) 5 1 — Do ^' C7 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: r r aJlRK- DETAI'L£Q DESCRUP IQ � ,F�►111/�f• _ 0 v Q_ , 8nv \ r© C_-Q__ AA-\ r i - dl CON i'RU.0 IC1N INFQ AMID'N Additional work to be pertormed under this permit- check all that apply: Gas Tank Gas Piping Shutters _ Windows/Doors _Mechanical _ _ :Electric _ Plumbing _ Sprinklers _ _-Generator _ Roof qf/ayitch t%:! 1 !! V F� T.66 q kFtiof Construction: i �r i Sq. Ft� of First `Floor: t �l, y�yl y � �>>� _.k/�.r';� i Cosf<of_'c' nstruction: $ . '� Utilities: # `Sewee,Yw � Septic Building Height: E 01lV R LE=-SSEE: _ CI NET OR: Name' _ Name Co�parY.I. !NG 1 Addres5; ° I City: �'-' c State: �: i Ca� Ad�r ssv t :" f ' ! t, Zip' Code: Fax: P - City 9 Ft. Pierce, F 34947 State: Phone -No. Zip Cody: 1 Fax: _ E-Mail: Phone No Fill in fee simple Title Holder on next page ( if different E-Mail O from the Owner listed above) State or County License If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SU°PPLEMCNI'AL CONST t1CTIo LrEN >A IN'' taR?MATt N; DESIGNER/ENGINEER: _ Name:' Address: Not Applicable I MORTGAGE COMPANY: _ Not Applicable Name: Address: P-T° City: State: Zip: Phone: City: State: i Zip: Phone r FEE SIMPLE TITLE HOLDER: _ Name: Address:_ Not Applicable BONDING COMPANY: Not Applicable Name: 4 lift Address: JVtrJ City: J Zip: Phone: s I City: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application isihereby 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 he fist inspection. m If you intend to obtain financing, consult with lender or an attorney before com ncin work or re ding ypur Notice of Commenceent. M i v Sig w r/ Lessee/Co ractor as Agent for Owner Sign re of Contractor/Lice se Holder S ATE OF FLORIDA 11 COUNTY OF �c �T �V �c STATE OF FLORIDA r ok-. Q/ N COUNTY OF c57a'I EDIT The for oing instr nt was a knowledge before me y The forgoing instrum t was aqknowledged before me this day of Q 20 by g this day of ✓Q. 20� by (Name of p rson acknowledging) (Name of person acknowledging ) a N°T'� Nof�A C� oyJ15 T < °Y�ys (Si tune of Notary Public- State of Florida) ^mac (Signature f Notary Public- State of Florida) Personal , Incy Known X OR Produced Iden ificatiol ,�+ Qe orally Woivvn 4 'OR Produced Identificat on o Type of Identification r„ o ) Type of Identification m 3 Produced N '' N CD " Produced. `� 33 ry' H. M N c' Seal Commission No. 4J 7 ! + ¢}�.r(r Commission No.GGS (Seal) . w 3 o co W M N . .dc a N REVIEWS FRONT ZONING SUIE1VIS R PLANS VEGETATION SEATURTLE M NGRQ�E COUNTER - REVIEW I REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED i Rev.7/2014