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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLET.� :OIR APPLICATION TO BE ACCEPTED ' Date: � -� 2A \'L SCANNE© Permit Number: BY" C St Lucie Coft RECEIVED Building Permit Application JAN 2 5 2018 Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 ST. Lucie County, Permitting 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 Legal Description: f Gty Property Tax ID #: 14V -6 )t - 6 39-Oa) Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: +U_6u. �h aJhkvtOdL�a�'layw�u2� CONSTRUCTION INFORMATION: Add itional work to e nertormed under this permit -check a [napply: ❑HVAC1:1 Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors Electric Plumbing Sprinklers 0 Generator ERoof 3 Total Sq. Ft of Construction: [((O 3 S . Ft. of First Floor: ` Cost of Construction: $ /o9gSGU Utilities:] Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name •F1e_Q ndd Name: u-5 - Address: City: gLqState: RL Zip o e:Fax: cc�� Phone No. '1-7c2 L(/g ���V Company: Address: ( ST -33L4 City: s�T�-�'' 1 Zip Code: _�>qQq-7 State: Fax: _77a a %T) E-Mail: Fill in fee simple Title Holder on next page ( if different Phone No. — %o - Q E-Mail:; 02 C � Cblu from the Owner listed above) State or County L ense: « If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:. 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: 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 of Owner/Lessee/Agent STATE OF FLORIDA 1 COUNTY OF Vat4;n The for oing instrume t was acknowledged before me this la day of Q 20 /by s Sign ture of Con r for/License Holder STATE OF FLORID�4 � on COUNTY OF [Q. The forgoing instrurnVrt was acknowledged before me thiz:5V day of 20 Oby (Name of person 9cknowledging) (Name of pArson acknowledgin 4L�� (Signs re of Notary Public- Stato of FI i (Signahre of Notary Public- SPat o Florida ) Personally Known OR Produced Identification Personally Known k� OR Produced Identification Type of Identification Produced a L Type of Identification Produced Commission No. "l 1 3: (Seal) Commission No. q(p (Seal) f J"pIffCCA RESTIFO My COMMISSION# GG91863 Revise /MMMISSION # GG91963 EXpURES: May 17, 2021 et .. TDoz. May 17.2021 � REVIEWFRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE 2, !3 r � COMPLETE INITIALS