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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLE rtb FOR APPLICATION TO BE ACCEPTED " Date: w I Permit Number: ' sue, 8� RECEIVED -- �•-• NED Building Permit Application BAR 16 20U! Planning and Development Services Permitting DepartmentSt. Lucle Coup*, 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: Ad`71 r s PreC Legal Description: Property ax l #: ,�3�cc-f �O) ©�� C, Lot No. Site Plan Name: Block No. Project Name: Setbacks . Front Back: I Right Side: Left Side: DETAILS® D'E�SCR�IPTION t?F UI/ORK: CA 1 T-"jg�kczu pus, z ;L J;iAA CONSTR,+l1CT(ON INFORIVIATI'0N: Additional work to be pertormed under this permit- check all that apply: _Mechanical _ Gas Tank _ Gas Piping —.Shutters Electric _ Plumbing _ Sprinklers _ Generator Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cst.-ofrConstruction: $ /o, 6c�)o Utilities: _Sewer _Septic _ Windows/Doors _ Roof Pitch Building Height: OUVN ER/LEStiSEE: CQNTRAG+�TOR: Address:-71 L.Jt��r iX�St `��• Company:'; Address: ' State: Zip Code: 25tig1.1 5 Fax: City: State: Phone No.22'ai?, 3aY —] / 41 ZJ,p Code: Fax: E-Mail: -Ty-b-e-C.kt�v a- �I��q�IL C (�vV� Phone No Fill in fee simple Title Holder on next page ( if different E -MV ail `' .' State or County License 7 rom the Owner listed above) , 7 If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. MPLE;_ DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: City: State: Address: . City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE, OLDER: _ 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 vour Notice of Commencement. ractor as Agent for Owner I Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF ��� �COUNTYOF The forgoing instrument was acknowledged efore me this G'& day of M d� f C,6 20a by / /,_ Ree Le_- (Name of p rson acknowledging) (Signature of Notary Public- St of Florida ) Personally Known OR Produced Id Type of Identification Produced Commission No. (Seal) The forgoing instrument was acknowledged before me this day of . 20_ by (Name of person acknowledging) (Signature of Notary Public- State of Florida ) c Personally Known off^ N Type of Identificat Cc w ® Produced c LL m N QO cc e � wN Commission No. m�c9 — ion OR Produced Identification (Seal) W0.NEj REVIEWS FRONT ZONING PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW DATE cn RECEIVED DATE =a COMPLETED Rev. //ZU14 I ��