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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED U Date: �� ��' �� Permit Number: \1 VkJ d 1 Building Permit Application DEC 18 2017 Planning and Development Services PL-RP4ITTi,NG 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: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: Pl G'2 M U, iL I G W Cl rict.V�—" .. PC U V i uccF- Legal Description: Property Tax ID #: 33�1 ' bd3' O \a� - a 04 ^ d Lot No. Site Plan Name: Block No. Project Name: N>95-9 SNawSR +z©d 111\. 81 a ?—Mu LL %c-W Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: N etu iit�9 S?+o�E2 l f.1 �w e=oc}F fi�r.9,-T+rR� 2ooF,� NEu/ CIF ( Olii't-�T .c�. RA'EN Room f l Pc� uJ W 7�st t� 2 Gs='t i o E"'1 vrz yf A Zzo . oVT+-E^r c� t2 �7 u�o ; To U- VJ-1 2E �✓t o v� y7b0 R &, Frt. A u�F . F t L t_.. Oe— e,J c IJ 6 w l & rU PS G YK � .CONSTRUCTION INFORMATION: Additional work to be nertormed under this permit - c ec a apply: I�HVAC Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors WElectric Plumbing O Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: t �' 'S T- Sq. Ft. of First Floor: is Sr . Cost of Construction: $ -2,4 40 - Utilities: Sewer Septic Building Height: OWN ER/LESSEE: CONTRACTOR: Name G"Rt,6ure,1 4 Bost tAnnv V LEv .i"j 6. Name: qR4�:-jL- CbST\L�d Address:_r1I ct2 1\ 0 zi_ t 6 ca QG Ga rtc%-E7 Company: `P Q �Ls>r Nc �►acz o �--Z-C . Address: 2_I 6 N \.1 P� E�sa�� Gn k1 ay City: Fo rr�-r S , U c c F State: Zip Code: 134-4 A,(, . Fax: City: a cZT S—, L-..cc cAE State — Phone No. q.02 6 .S-C "It Zip Code: '-�4g8,C Fax: E-Mail: A- Phone No. S61 6,9s 1 Fill in fee simple Title Holder on next page (if different E-Mail• .bt i i l d t•,n o c,,Jor pp from the Owner listed above) State or County License: C6 (S (I e q If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. Qj "10 11 SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I NER/ENGINEER: _ Not Name: C1*3 !emu tS . Address: City:Ai�X/ s� 1-1c-yc�ERrati State: V - Zip: vaP4AjoxPhone -752_ (R4 9 3S8Q FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: _Not Applicable Name: 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, I ccessory 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 worK or recoraing vour Notice oT LOmmencement. Signature of Owner/ Lessee ontracto as Agent for Owner STATE OF FLORIDA/1 COUNTY OF . 1�11Ci,I The fooing instrument was acknowledged before me this 1 day of 2011 by % a\) \ cW-- v\ ,t a Name of person making statement Personally Known OR Produced Identification Type of Identification Produced i X- L (Signature of Notary PtNlic- State of Florida ) Commission No. . DEANNA MARIE GIVENS W1, Cokp4 ,ISSION # GG 022023 =.'•;� o�:� girded llrnr Notary Pul lie Underwriters OF Fes,. REVIEWS l REVIEW I REVIEW RECEIVED COMPLETED Rev. 8/2/17 Signature of ontractor/License Hol• e . STATE OF FLORIDA COUNTY OF iL�m The forgoing instrument was acknowledged before me this L!S_ day of L%% . 20_JI by Name of person making statement Personally Known OR Produced Identification Type of Identification Produced (Signature of Notary iE ; D NN M11.ARIE GIVENS Commission No. `� , _ MY C $ION # GG 021023 =d oc EXPIRES: December 16, 2020 Bonded Thru Notary Public Underwriters PLANS REVIEW I VEGETATIEV EWON I SEA REVIEW TURTLE VEWLE I ME EWVE