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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COM Date: a FOR APPLICATION TO BE ACCEPTED Permit Number; SCANNED 13`f St Lurie C©Unty Building Permit Applica FEB 2 6 2018 ST. Lucie County, Permitting Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LQCATION add , �;?, ri /D *0//2 c ufeC 0 cR, c C, Legal Description: a4/oZU 1?0 Site Plan Name: Project Name: efbac es Front�z Back: DETAILED DESCRIPTION Of WORK:. 1. J Lot No._ Block No. Right Side: Left Side: s CONSTRUCTION INFORMATION Additional work to be pertormed under this permit- check all that apply: _Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Cost o Gonstr_u_ctio�i: //99 7 c' Sq. Ft. of First Floor: Utilities: —Sewer —Septic Building Height: W N ER/LESS;E E: ,. ., o CONTRACTOR: Name Name: Address: o-? "2/0 N/hGu/k:::GeJ ,r/? Company: Address: City: 'E0A %ley-tc'i State:/�L Zip Code: 99 C%d 1 Fax: City: State: Phone No. `77c�z „ m /U©.3 Zip Code: Fax: E-Mail: /ee_n ch;&/� Qf2'IA/4 ['_�N'1 Phone No Fill in fee simple Title 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. i ff SUPPI�ElV1EITALC{NS1 71QN LIEN :W 1NFOt11/iATIQN: �? DESIGNER/ENGINEER: _INot Applicable MORTGAGE COMPANY: Not Applicable Name: Name. - Address: I f `' Address: City: I State':` o , City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: I Address: City: I City: Zip: Phone: I Zip: Phone: I OWNER/ CONTRACTOR AFFIDVIT: Application is.hereby madb 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 such prohibit 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 tolRecord 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 commencing work or recording our Notice of Commencement. I Signature of Owner/ Lessee/Contractor as Agent for Owner 'Signature of Contractor/License Holder STATE OF FLORI A STATE'OF FLORIDA COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this'b,�_ day of -.S1,r .20 by this day of . 20_ by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary blic- State of Florida) I (Signature of Notary Public- State of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification �� 0L- Type of Identification Produced Produced __-=' GNEPIS p��NAPdAR1E Y PV3� y COti14u1tSS10N # GG °023 g;®ccembet16.2°21 Commission No. 10.5 \, detwd ommission No. Seal (Seal) x ;a_ NFublicUn zq , P- gondedYhN REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW I REVIEW REVI REVIEW REVIEW REVIEW DATE RECEIVED DATE I 3�2( lie COMPLETED Re—v.