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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLEiE,u'FORAPPLICATION TO BE ACCEPTED �1 Date \ ad �$ li SCANNFO Permit Number: 1--,%,C! REC VET APR 2 0 '018 Building Permit Applicati Lucie County, Permitting Planning and Development Services 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: Address ©r) L n Legal Description: 14cWx Nw B Ties h6Lcv---1 L-c)+ Property Tax ID #: 12,1a — S Oa i oN �05 - oco ` C) Lot No._ Site Plan Name: Block No. 2{ Project Name: t7flbrN �I Setbacks Front Back: I Right Side: Left Side: J e Additional work to be pertormed under this permit— cneCk all that apply: _Mechanical _ Gas•Tsnk . I— Gas Piping _ Shutters _ Windows/Doors i _ Electric Plumbing L Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of ConstructionII , Sq. Ft. of First Floor: : d� Cost of Construction: $ a %Q-75-. CAC7 Utilities: —Sewer _Septic Building Height: Name 1 �1-0-(� Address:_5?2'bN' SuSon ca(ve, City: r-+ ?wfQ. - State: - Zip'Code:q Fax: Phone No. 75 oq. a Lj-59 E-Mai1: b1T)0-fN IINe'S @ fCc0A 4 Col Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name: Company: C©oke's Plum& aloe, t6 Sent. Address: 3100 Si✓ City: 530A&Ar State: ML Zip Code: Fax:110-aarl` IS90 Phone No -113' J c7'1' Q (Cs E-Mail C .VGva12 (aVg, && ryb M c!o-wi State or County License. taSfo (off y If value of construction is 2500 or more, a RECORDED, Notice of Commencement is required. SUPPLEMENTAL CtONSTRUCTION II.E LA ( 'FORMATION: DESIGNER/ENGINEER: _ Not Applicable; MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: I Address: City: City: I Zip: Phone: 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 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 N,'otice 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 your Notice of Commencement. I I I Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA I i STATE OF FLORIDA COUNTY OF 12T) COUNTY OFF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this -Li day of this _j�qday of 20� Vby IyNLI `�I S�Jd� �sN1� A �) B i'2l i✓ (Name of person acknowledging) (Name of person acknowledging) (Signature of No Public- ate of Florida) (Signature of Nota Ptate of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced M-5 DONNA ZIBRIN Commission No. MYSCON�¢{��TnpN#FF234297 Commission No. 49MRAZg MS' ; Jiiffliy 09, 2019 t OMMISSION fi Ptr23d2§9 EXPIRES of July09,2019 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 7/2014