Loading...
HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONF1 k All APPLICABLE INFO MUST BL %.wMPLETEv` rJR APPLICATION TO BE ACC-., D = M)v Date: Permit Number: SGANNE �M .RECEIVED .- ll St Lode Comb/ MAY 14 7010 i Buildin Permit Application' g pp Permitting Department Planning and Development Services St. Lucie County 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: P'RQ' C�?SED INPR®UEM�E T LOCATION: Address: L o ic:7• 4:"&,Wt5 ,me, 3 / 9 Legal Description: w A late e_1 1 L_ 14 2 A) P/Z bf L0' r i Z � 0.�z5 ,4e--) Property Tax ID #: Lot No. -a Site Plan Name: Block No. Project Name: Setbacks Front Back: Rig t Side: Left Side: DETAILED DE�SCRI1251ION OF 1N�R+K JU COM:RoTI itNT ionawCorrider t is permi—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: Sq. Ft. of First Floor: Cost of Construction: $ , ,7�1'� Utilities: —Sewer —Septic Building Height: OWNER/LE=-S�5EE: C©NIT, RAw : Name C1 %Trtl D Name:' Address: #/'0 3 & i1?CA/ Company: T- City: FO&K State:,g� Address: City: State: Zip Code: Fax: Zip Code: 47N.9 97,-- Fax: Phone No'. �� SZ$��f0�6� E-Mail: Phone No E-Mail Fill in fee simple Title Holder on next page ( if different State or County License from the Owner listed above) if value of construction is 2500 or more, a RECORDED N tice of Commencement is required. &MPPLEMENTAIN: C1 ST=ION L1EN LAW INF�RMAT ON: DESIGNER ENGINEER: Not Applicable / — pp 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 r ing your Notice of Commencement. i ur of Owner Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDqq STATE OF FLORIDA COUNTY OF S �4..r. �, COUNTY OF The forgoing instrument was acknowledged before me �kk VyViup The forgoing instrument was acknowledged before me this day of 201A by 11 this day of , 20_ by ,1n Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced • Alp GH Il �Seat re of Notary Public- Statb of Florida) (Signature of Notary Public- State of Florida ) 't Commission No. (Seal) Commission No. (Seal) . 1111 Ifl. -^ REVIEWS \\\ti �R !>(�e 1, a, , OV° . LIB I IM1IIIV h1 lnta hl c - sta Z,�IVGsOR M PLANS VEGETATION SEATURTLE MANGROVE n # F REVIEW REVIEW REVIEW REVIEW DATE 8 nded through Nation I Notary Assn E' RECEIVED DATE COMPLETED ev. 8/2/17