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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE'CON'`".';'�TED FOR APPLICATION t0 BE-ACCEPTEL' Date: eW% Permit Number:�� & L UPle d(Jty RECEIVED Building Permit Application MAY 0.7 2018 Planning and Development Services Permitting Department Building and Code Regulation Division St. Lucie County 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462_1578 Commercial Residential i PERMIT APPLICATION FOR: Address:! Legal Description: Property Tax ID #: O U '"— �� Lot No.4 Site Plan Name: Block No. Project Name: �� —� $etbacks Front Back: Right Side: Left Side:. I _Mechanical — Gas Tank Gas Piping — Shutters Electric — Plumbing — Sprinklers — Generator Total Sq. Ft of Construction: ©- Sq. Ft. of First Floor: _ Cost of Construction: $ '53nC,2 Utilities: —Sewer Septic _ endows/D ors Roof ` v Pitch Building. Height: t % OUVNER/i111&WSEE: CONTRA Name —C Name: Company: Address: City:` 2--�� State. �._ Address: City: State:�L, Zip Code: Fax: Phone No. ' Zip Code: Phone No ''(.::71'Z^S!5ACC ax: E-Mail: Fill in fee simple Title Holder on next page (I 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. 03FRORME-70110L EM STR++ CT N LIIIENSI&W INE � a ATlON: 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: 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 your Notice of Commencement. I � , Signature of Owner/ Lessee/Contractor A Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY COUNTY OF qz'& •s� The forgoing instrument was acknowledged before mel The forgoing instrument was acknowledged before me this day of iY 20L by this r_ day of Yy\r,,b, 20 V% by Name of person making stateAlrit. Name of person mak g statement. 7 Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Prod ce Produced (Si at re of Notary Public- State f Florida) (Sig ature of N tan�,Qt;�ljc- eof;loriGRAM Notary Public - State of Florida Commission No. _ L. _(Seal) LASH INGRAM Commission N `� - Comm. t>;pire(Seal;)0 201B :^,F Commission ,,,,, r, i, " Public - State of Florida ,i : i=\�. Noiary t' oFo f6 FF 1772A9 i OF F4 .." Borded tti rr an�� n Ints- A — REVIEWS _. , FRONT=.�F'. M Gomm. J >.pires G 7 9n PLANS VEGETATION SEATURTLE MANGROVE hS�jP COUN'TEI�%°� 4NIN-L9mmis �2�VFEVr)�hrouE,ta, 'REVIEW REVIEW REVIEW REVIEW DATE ' ` - ✓ RECEIVED DATE COMPLETED Rev. 8/2/ 17