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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETEti WR APPLICATION TO BE ACCEPTED Date: N3 Is Permit Number: N40�- o3aA SCANNED KtCEIVEC ­" o �,��nip 3 2018 st ud Bill ding Permit Applic t" 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 V PERMIT APPLICATION• ' i i Address: 59'09 eamboo Dr. Legal Description: --Chdia?) R%v-ey' Esfyfes -qn/--©9- 6/iG 66 Lofs 2/ 9n 7, CAMP 5 /125) or' 2. g2/ - /6/0 Property Tax ID #: 310 Z /O - 0¢$/- 000 - / Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: 2e� ai'r Pool , screw /o o s e onal work to be pertormed under Mechanical Gas Tank Electric _ Plumbing Total Sq. Ft of Construction: Cost of Construction: $ i p() permit - cneck a Gas Piping Sprinklers apply: _Shutters Windows/Doors _ Generator _ Roof Sq. Ft. of First Floor: Utilities: —Sewer _Septic Building Height: Pitch QUI/INER�SSEE:; C � N RACT4R; Name Rosh; h i 4-q K✓q vY1 Name: Address: 57 3 S A l&J Sq ke, Company: City: Porf st. I-e4ciC State: Zip Code: 3498(0 Fax: Phone No. 772 - 6'19- 43.2 9 Address: City: State: Zip Code: Fax: Phone No E-Mail: R0SC1 Lq/ce (3 40/• G041 Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail State or County License If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. uPP� NTH caru��R raN LI RON It.a►w 1 ®AMA► ro ; DESIGNER/ENGINEER:.' _Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone -Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: 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 commencing work or recording your Notice of Commencement. Signature f Own r/ L ee7cpritractor as Agent for Owner Signature of Contractor/License Holder STAF�SLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instrume t was acknowledged before me The forgoing instrument was acknowledged before me this V3 day of �� , 20 14 by this day of 20_ by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced j (Signature of Nota v . (Signature of Notary Public- State of Florida (g ryCommission r-da""DEANNAMARIEGIVENS MYCo1�I018SION #GG022023 No. = API ®ember16,2020 Commission No. (Seal) a: '••",;eoFF�o Bonded Thru Notary Public Underwriter REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW_....... REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.872117