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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLE i ru FOR APPLICATION TO BE ACCEPTED Date: l Permit Number: J MANE J s Y = RECEIVED M St Lue!� Comb/ Buildin19 Permit Application MAR 2 8 2018 Planning and Development Services ST. Lucie County, Permitting Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 COm'mercial Residential !� PERMIT APPLICATION FOR: P'RQPOSED, INPROVEiVlENT LOCATION , Address: Legal Description: tiy /-i- 1I-'- y c— s —/ , " / c suer_ 10 , 9Ll- l S . (gccr�rd, io A off' L-Mcv, Property Tax ID #: . — Go © Q'�> Lot No. qo(- /0 Site Plan Name: r Z Block No. 5 Project Name: Onm .S�L_ Setbacks Front- 3121 Back: Right Sii de: (:�l s3 Left Side: DETAILED DESCRIPTION OF WORK: Ct?NSTR_UCTION IN Additional wor to a pe orme un'cier t is permit -crieCk all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters Windows/boors Electric _ Plumbing _ Sprinklers _ Generator —Roof Pitch Total Sq. Ft of Construction: 1_ 5-OCR S6r Sq. Ft. of First Floor:,Jyb.a Sr -- Cost of Construction: $ - P �00 Ce Utilities: —Sewer —Septic Building Height: OWNER/LESSEE:. CONTRACTOR; Name 4- C r ,-S Name: Address: 7 ?oy roc jo-( tcJ�') 4y/z- City: F- 1'i elC-c- State:'Z� Company: Address: Zip Code: �`�`r� I Fax: City: State: cy� Phone No. % % �L S� �3 S�i9 Zip Code: Fax: Phone No E-Mail: /0OCt 6-rA ..)&9t4.- (j-rn 1, C® 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. "M 1PPlE /1 I ABC€ N TRI T t3 i. V 1 1N IN NIAi` { et'gn ,1 DESIGNER/ENGINEER: I Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address:,- -; ; - ; I Address: City: I I State: City: State: Zip: Phone I Zip: Phone: 11 FEE SIMPLE TITLE HOLDER —I Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: I Address: City:_ I City: Zip: Phone: I Zip: Phone: ' I 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 tl�iat 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 arle 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 inspectiorQf you intehd to obtain financing, consult with lender or an attorney before commencin&jy9A-V5_ec6fiding your Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA I STATE OF FLORIDA COUNTY OF COUNTY OF The for g instru t was acknowledgECIbefore me The forgoing instrument was acknowledged before me this ay of 20AI by this day of 20_ by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notaryic- ate of Florida )1 (Signature of Notary Public- State of Florida ) Personal) Known - OR Produced Idenitification Y i Personally Known OR Produced Identification Type of Identification Type of Identification Produce at.,. er Florida Produced Pnlaite 'e 0rendi J Keeney Commiss' Q M sion commisGG089390($e 2 Commission No. (Seal) V, o Expires OF F� I REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE 1 RECEIVED Z4 a DATE COMPLETED ev.