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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE C:unMPLEI ru FOR APPLICATION TO BE ACCEP` r� Date: )-' SGANN�0 Permit Number: 1 RECEIVED Building Permit Applicatio MAR 2 6 2018 Planning and Development Services Building and Code Regulation Division .1 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Address: Legal Description: Property Tax ID #: Site Plan Name: Project Name: Setbacks Front Back: , r,(a r Right Side: _Mechanical _ Gas Tank _ Electric _ Plumbing Total Sq. Ft of Construction: Cost of Construction: $ (on , Do ST. Lucie Cou*, Permits;na Residential Lot No. / Block No. Left Side: O / 'ma- cnecK aii tnat apply: Gas Piping I _ Shutters _ Windows/Doors Sprinklers �� _ Generator _ Roof Pitch Sq. Ft.lIof First Floor:. Q� 1A Utilities: _Sewer _Septic Building Height: t OWNER%LE=SSEE: CER, IT, T©R: Name CEO a- Name:!, Address: Company: Address: City: ROO-R"Pkrs? State: City: State: Zip Code: Fax: Phone No.�'31 (�j��( ?�i nlZ3(8-50—%�y� Zip Code: Fax: Phone No E-Mail: o M Fill in fee simple Title Holder on next page different E-Mail from the Owner listed above) i State or County License If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUPPLE , �NTAL Ctd}NSTRUCTI * N LI N LAW I'N�OR}MA 110M DESIGNER/ENGINEER: Not Applicable MORTGAGE, COMPANY: Not Applicable Name: Name: . Address: Address: City: i State: City: State: Zip: —.Phone' I I Zip: Phone: FEE SIMPLE TITLE HOLDER: i Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: I' Address: City: City: i Zip: Phone: Zip: Phone: i I OWNER/ CONTRACTOR AFFIDVIT6 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 represe which is in conflict with any applic structure. Please consult with your that is granting a permit will authorize the permit holder to build the subject structure me Owners Association rules, bylaws or and covenants that may restrict or prohibit such 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,ithe 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,ifences, walls, signs, screen rooms and accessory uses to another non-residential use WARNING TO OWNER: Your fai improvements to your property before the first inspection. If yc commencing work or recordin ure to Record a Notice of Commencement may result in your paying twice for . A Notice of Commencement must be recorded and posted on the jobsite i intend to obtain financing, consult with lender or an attorney before our Notice of Commencement. Signature of wner ssee/Contractor as Agent for Owner Signature of Contractor/License Holder ' STATE OF FLORIDA I STATE OF FLORIDA COUNTY OF �: U) Cl F COUNTY OF The krFoing instrument was ack lowledg before me this Qday of IPd(l1i by The forgoing instrument was acknowledged before me this day of by .20 i .20 i (Name of person acknowledging) (Name of person acknowledging ) 1 I i I (Sign ure of Notary Public- State of Florida) I (Signature of Notary Public- State of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of lclentiffi.gation i Type of Identification Produced NIELSEN Produced Commission 8 FF 115637 Commission No. '$ Expires Commission No. (Seal) -s 'c June 12, 20� ff�fl111111"` REVIEWS I FRONT i ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.