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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMF�.-.��D FOR APPLICATION TO BE ACCEPTED Date: Apr . \ 2r6 ZG �� Permit Number: 1A�J! RECEIVED il r 9r.1P rR1MtV, APR n 2 2018 _ - Bul ng Permit Application Planning and Development Services Permitting DepartmeW St. Lucie County Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (7,72) 462-1578 Commercial Residential _ / PERMIT APPLICATION FOR: Address: S k O ' Legal Description: Property Tax ID #: 13 1 'z — Site Plan Name: Project Name: Setbacks Front Ilo ri�i LQ1i6 C44 i I Back: ' Right Side: Left Side: Lot No. Block No. �'Z_nce 2 &CkAe5, c n ecAcV) Gv r -A ,. _ Cyr») 1 L Z 1;11 ? /Y r 4 7 \ (0 Aaaitionai worK to oe perrormea unaer tnis permit— cnecK aii tnat appiy: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $J ©d Utilities: —Sewer —Septic Building Height: QUVN!ER/1.E=�SSEE: CaN� RAC�TI.4R: Name I-G1 V'CA ' Cc" ne Co e v— N:ame: p CAddress: ���t; PCA QY rCCompanyi`: City: FC,rA 9� er'Ce State: FL- Address: it State: Zip Code: ?,'-ILLS Fax: Phone No. T 2 - SS2 --"d U2 q _Zip;,C91de: 1 Fax: '-Phone-Noi E-Mail: XGX T \!S 12 0 GO 1. CC0✓1 Fill in fee simple Title Holder on next page ( if different +7E-Mail. �state`or County License from the Owner listed above) If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CMNSTRUCTION Zu& INFORM 7, M DESIGNER/ENGINEER: _ Not Applicable Name: Address: City: State: Zip: Phone -------------- MORTGAGE COMPANY: _ Not Applicable N�ariie: __._ ... . Address: 'dIty: State: Zip: Phone: I ' FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: Not Applicable Name: Address: Address: City: Zip: Phone: City: Zips: 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 lauthorize 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 undergoinglla 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 commenc' work or re_cor4jng your Notice of Commencement. _z Signature of Owner/ Les Contractor as Agent for Owner Signture of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this %day of / L. 20by this day of 20_ by (Name of person acknowledging) (Nam i of person acknowledging) (Signature of Notary Public -prate of Florida) (Signal ure of Notary Public- State of Florida ) Personally Known OR Produced Identific ici& Personally Known OR Produced Identification Type of Identificati 2 Produced �C/ g m Type of Identification Produced 'aw._ $ Commission No. (Seal) Commission No. (Seal) :Stete of PI REVIEW �� ate oflPI r' y 2 9My u 4 li pE I� PLANSI'� VEGETATION SEATURTLE MANGROVE ,,„ �U 0n►.6Afsllklk`�lfcpires EVI$ REVIEW REVIEW REVIEW REVIEW DATE . o RECEIVED . DATE COMPLETED Rev. 7/2014