HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FORIIAPPLICATION TO BE ACCEPTED
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Date: - b ' Permit Number: / O o's—
:�— `. a ��;,`IIg'ffpp���11 RECEIVE®
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>riit Application' MAY 0 8 2018
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie C ilt�/, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT APPLICATION FOR:
PR4P05iED:INRROVEMENT LOCATION 1 °
Address: S
Legal Description:
Property Tax ID #: 7—LkC5'"" -� D �l.lZl'-�C�f���
Lot NoZ`
Site Plan Name:
I
Block No. 7
Project Name:
Setbacks " Front - Back:
Rigt Side:
Left Side:
DETAILED:'DESCRIPTION OE WORK ;Of
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CONSTRUCTION°INFORMATION
_. .
Additionalwork to be pertormed under this permit '� checkk
all that apply::,
_Mechanical _Gas Tank
_Gas iping
_Shutters
Windows/Doors
_ Electric _ Plumbing.
I
_ Spri I klers
_ Generator
` s_
V Roof %,050'� Pitch
Total Sq. Ft of Construction: 74W
;
Sq. Ft. of First Floor:
Cost of Construction: $ .000.010
Utilities: —Sewer _Septic
Building Height: I d
Q)NNER/LESSEE: " ; . °. ; :,":
XONTRACTOR;
Name
Name:
Address:;F
Company: �C
City: State:
Addre s
_
Zip Code:�� LQ Fax:
City: C State:]Be
Phone No. �77�"'��jg-7D?D `
Zip Code: gjA! 7L- Fax�7Z Sd
E-Mail:
Phone No
Fill in fee simple Title Holder on next'page ( if different
E-Mail QXSeA
from the Owner listed above)
State or County License _ ezzos7i
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
77111-117
Slt,PPLEMENTAL CUNSTIiJCTlaN LIEN LAW [NFPRMATIQ.N77
DESIGNER/ENGINEER: Not Applicable
•_. PP
_. _.
MORTGAGE COMPANY: Not Applicable
,Name:.:'..:_ _
Name:
iAddress,:
Address:
State:
City: State:
'Zip: Phone
Zip: Phone:
,FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
;Name:' ':; _ i
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
bylaws
which is in conflict with any applicable, • Home Owners Association rules, 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 ' site
before the first inspection. If you intend to obtain financing, consult with lender or an attor y befe
commencing work or recordingour Notice of Commencement ��
Mudr
.
Signa re of Owner/ Lessee/Contractor as Agent c9@
Signature of Contractor/Lice �w•�
MEE-
STATE OF FLORID ��
STATE OF FLORID
COUNTY OF �w $
COUNTY OF m
The forgoing instrument was acknowledge re
The f oing instrument was acknowledge
this day of 20
this day of
,Z a rr�--
(Na02!_9f person acknowledging)
(Name of person acknowledging )
(Signature otary Public- State of Florida)
(Signature of Notary Public- State of Florida ).
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
Commission No.. (Seal)
Commission No. (Seal) '
REVIEWS
FRONT
ZONING :r .
,SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 7/2014