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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FORAPPLICATION TO BE ACCEPTED (, / < V( Date: $ Permit Number: I Ot p'C73 SCAN 0 smuciecou RE ("0" E "W"m D Building Permit Application Planning and Development Services MAY 2 5 2018 Building and Code Regulation Division � � permitting Department 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial es ftnWide County, nty, FL �1 ,�.�►ov¢. •ey.iS ,n�cov$ S1r,iY,4L5,It�ZJL wt�-l�..Y`ne.�0.,1 1 yrnA zi,- C{ NSTRU.CTION INEORIVIATO r- -Mclitional work to be nerformed under t is permit -check a apply: 11HVAC L_I Gas Tank Gas Piping _ Shutters Windows/Doors Electric ❑ Plumbing Sprinklers Generator ® Roof © Roof pitch Total Sq. Ft of Construction: S . Ft. of First Floor:) %� Cost of Construction: $ A% _ S Qb . O O Utilities: _ Sewer Septic Building Height: Name (jII(,,4w, An Ul M`-- e174,eq Name:LLQA�J1n LGCi Address: a i-/ _C.t_y_ /6 's C'_ Company i�0 o L�"Ot S City:1111(I nJ0 h ;,S 1»nd State: F1 Addressc),SSb SE r:Nc A , & Zip Code: SL%9 `� 9 Fax: �i % Cit r(. Si . uu e. L Stater Phone No. �`7 01 ��n - �� �% Zip Code: _j_:H!5 5 -a, Fax: -Ij I -A E-Mail: r1i �A Phone No. Fill in fee simple Title Holder on next page ( if different E-MailA 0'i C�ciS;�.,nSe,�.-'111 n� Q ma�1•Co' from the Owner listed above) State or County License: U-P. 3a.le loa, h If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. L SUPPLEMENTAL CONSTRU,CT(ON LfEN,LAW INFORNIATCQN. DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: I Address: City: State: City: State Zip: Phone I Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: I. Address: City: i 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 Corinmencement 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 our Notice of Commencement. I i Sign ture of Owner Lessee/Contractor as Agent for Owner Sign ture of Contractor/License Holder STATE OF FLORID / COUNTY OF 31. y e" Imo, L ,i STATE OF FLORIDA ( j COUNTY OF The forgoing instrument was acknowledged before me I this day of AJAy 20 Z by The for oing instrumme,nt was acknowledged before me this day of /�t✓��/ 20f-by Name of person making statement Personally Known OR Produced Identification Name of p rson making statement Personally Known OR Produced Identification Type of Identification Type of Identification Produced roduced (Signatitre of Notary Public- State of Floriday)= (Signs re of Notary ublic- State of Florid SrA k, MARK KENNY �(gg Commission ''• °n#GG144�144991) �� Expkes September 19, 2021 O OQ Eanded7MuBud9atNopryServkea '-0 :p MARK KENNY Commissi o'' Fsie�#6G1444 (eal) Expires September 19, 20 FOFF�� Booded7ArveudgatNotarySwrloat REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REV! REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17