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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLEYEu'FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 1 1$ l� (O6 ct iJ AM :ram St Lucie Coon Building Permit Applicati 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:.S` 9 �r ' �v,Q�l�I �1a PR'OPOSED.1NPROVEMENT10CATI';, ,., ;'... Address: �(�' JS 6�r1 lfemme ✓may fn Legal Description: 2 l 2—, I, % 31 D (aLZj 3/_L6773) z Property Tax ID #: © — 6o7— L93 50—ad%� - 21 Lot No. �Q✓ Site Plan Name: 4e vor Block No. U Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION 0F.WORK: 1 skl/ 7 jr-1 AYE ,%- oW_e%Se_'/.J, Vt s/ r�/Z 00 MAWR RECEIVED JAN 3 0 2018 ST. Lucie County, Permitting 01N(dEk/LESSEE CONTRACTOR. Name > d d •f Name: v Address: a /'W Company: ? e' e City: i� /" l�`��cP State: G Address: Zip Code: Fax: City: 142r f me-C State: Phone No. 7512 e—,�fj jo_F Zip Code: '? Y% Fax: E-Mail: Phone No 122 q2-4`1 Fill in fee simple Title Holder on next page ( if different E-Mail Co&--t from the Owner listed above) State or County License /"J?C d (2S%Z2e If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. I SUPPLEMENTALCONSTRUCT!C1N LIEN LAW tN ORMATION• s.. A DESIGNER/ENGINEER: I _ Not Applicable MORTGAGE COMPANY: Not Applicable Name: °'-Name. _ = Address: I Address: I State: City: State: .City: Zip: _Phone; I I Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable ;Name; i Name: Address: - - - I Address: City: 1 City: Zip: Phone: I Zip: Phone: I OWNER/ CONTRACTOR AFFIbVIT: 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 yointend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE.OF FLORIDA STATE OF FL0 Ina COUNTY OF 5�. Lyc�e COUNTY OF before me The forgoing instrument was acknowledge b ' or'�a^st The forgoing instrument was acknowledged before me ' this day of . 20 \ by this day of . 20A by (Name of person acknowledging) (Name of person acknowledging ) (Signature of Notary blic- State of Florida) (Signature of Notary blic- State of Florida ) Personally Known OR Produced Identification Type of Identification Produced L- L, I Personally Known OR Produced Ident' 'rat' • d Type of Identifi tion GNENs Produced DE�NAAN{yGG022023 �' �. Npe�1PR�EGN J227.30 OSypN GGer S10N 020 1S m er •2 Commission No. �� 4tij `': M`►(�� e� b 16 denyd��' 16.2020 Commission No. t� .,. �XPIR Uc(� cUn�,�1' o1aNPcb1\c -_. a' � ""�• . cc gonded�hrutl dza-�hnit REVIEWS FRONT ZONING SUPERVISOR PLANS Val - VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED I DATE COMPLETED I ev. 7/2014