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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE'ACCEPTED Date: 1 Permit Number: SCANNED) ®Y RECEIVED St Lucie Counhi • MAY 0 4 zm - Building Permit Application Planning and Development Services ST. Lucie County, Permitting Building and Code Regulation Division I ` 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Comme rcial Residential PERMIT APPLICATION FOR: IMPROVE MENT LOCATION: Address: C r C ✓ e 1Z. (�t cwt _ 60 \Jl G Legal Description: LdT / 6 13/yc lL lyY7 Pow S�. `e Seiyv .><Pe•�. rrGL D ✓ G' 'r t' 71� � � ,P � � �'T � �+ Property Tax ID #: I ) 0 0 - 1 Lot No. Site Plan Name: Block No. Project Name: 24 e JII vol s �� ve�c�%o;w� Setbacks Front 1 ack: GC - I�ight Side: Cv.. LeftSide: DETAILED DE�SC•RIPTION OF VNOR�K: Eli N e b ,-•7e t // 1 / 2- c;,+v �ONSTRUCTfON INF©RMATION: itional work to 5e pe orme un er t is permit - c ec a t at app y: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors ` Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: 3 ZN '1 Sq. Ft. of First Floor: 3 Z y -7 / v,,,Je— /1 iiz 2 3 y r Cost of Construction: $ 5-1 6 _ Utilities: Sewer _ Septic Building Height: OWNNVROW -�S�SEE: CONTRACTOR: Name 5,) 11 j M Name - Address: 2 & 1 B,L J, Address: Company: Address: City: 7 � PI-e -c c State: 7C- City: State: Zip Code: 3L19N 9 Fax: Phone No. `7 7 -L - 2 ( fo 2 3 o 3 Zip Code: Fax: E-Mail: 4 c J'v w 4 Oran 6 v v. c o, Phone No Fill in fee simple Ti le Holder on next page ( if different E-Mail from the Owner listed above) Stat r County License JEvalue of construction is 2500 or more, a RECORDED Notice -of Commencement is required. Stl�RPLEMENTAL CNNSTR CTIt*7N LkEN L.AW uN't=ATI@N: 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: City: Address: 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. Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORI A STATE OF FLORIDA COUNTY OF S V. Lac �� COUNTY OF The forgoing instrument was acknowledgecL before me The forgoing instrument was acknowledged before me this day of ON Q\y % 20 by this day of , 20_ by fin. 4--, WN c M `% • \ Y1 (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Pu lic- State of Florida) (Signature of Notary Public- State of Florida ) Personally Known OR Produced (dent' Ai Personally Known OR Produced Identification Type of Identification .���� p tIEGNE'S Type of Identification Produced �f� i% L•tY'?u•pyiI�ISSION#GGO_2023 16, 2020 Produced - ° Q_ EXPIRES: December_ Commission No%sqT eor(�al)�IiotaryPublicUndenerifers ommission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Nth Rev.