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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COIVwr ETED FOR. APPLICATION TO BE ACCEPTS 4. Date: Permit Number: RECEIVED ,■,Luelp, MAR ' O 1 2018 _ Building Permit ApplicatiorPermitting DepartmentSt. Lucie County Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: Address: (d 7% Legal Description: L &d Commercial Residential Property Tax ID #: ,>� %) a !� Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: 45 _Mechanical _ Gas Tank —Gas Piping'' . —Shutters _ Windows/Doors Electric _ Plumbing _ Sprinklers, _ Generator _ Roof Pitch Total Sq. Ft of Construction: %ost of Construction: $ 1 l oo • 00 III Sq. Ft. of First Floor: Utilities: —Sewer _Septic Building Height: N NOWNRY/il ERSEE; Name P41 1L.{Ci1A /�� /�fl ame:CQNTiRAC«TOR. �... _.:.. ; Company:'n Address: + b� il. �D,t� f�UL' Address: 6'%64CCr� /� City:) R �4 �'' 6-':. State. Zip Code: Fax: Al /A- 1- - -- City: - State: Phone No. 7 f7J, Zip Code: Fax: Phone No E-Mail: A) 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. 7 S 'PPL � E h �(�? �iR� t..l' �N W I � `� • � ATl� _ DESIGNER/ENGINEER: _!Not Applicable :, -MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: i State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE71TLE"H'OLDER: I Not Applicable BONDING COMPANY: _Not Applicable Name: I Name: Address: ! Address: City: I City: Zip: Phone: Zip: Phone: 1 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, th'e 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. AINotice 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. LA ►" / Signature of Owner/ Lessee/Contractor;as Ag t for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA / COUNTY OF S� wG,;, I I COUNTY OF The for oing instrument was acknowledged before me The forgoing instrument w acknowledged before me this '/ day of ni�/riln , 210_&by this day of 20_ by (Name of person acknowledging) I (Name of person.,acknowledging ) (Signature of Notary Public ate of Florida) I (Signature of Notary Public- State of Florida ) Personally Known OR Produced Identification , Personaally Known OR Produced Identification Type of Identification Type of Identification Produced . L. , Produced \ otpar r�B.: HEATHER BUR Commission No. of Florida Nora y�j Sion No. (Seal) +�2Slate ommission # GG My Commission E 183217 Aires REVIEWS FRONT ZONING SUPERVISOR VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE ` RECEIVED I DATE I COMPLETED ev. I I