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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONj All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: lIc • )J ' IT Permit Number: do L - 0 -4 SGAN NhU .11 ' Building Permit Applicat'on JUN 15 2018 Planning and Development Services Pe rr I t�l tl g D e p a rt111 e 11 Building and Code Regulation Division COUCItY, FL 2300 Virginia Avenue, Fort Pierce FL 34982 St. LUCI Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Reside PERMIT APPLICATION FOR: b�,F P�_ Address: YV6 Legal Description: Property Tax ID #: L3/pl Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: -c> 2p w 12�x=w c Lot No. Block No. Aaaitionai worK to De perrormea unaer rnis,permmt cnecK an -mat appiy- Mechanical Gas Tank — Gas Piping, ,' _ Shutters _ windows/Doors Electric. _ Plumbing ' _ Sprinklers-,:! Generator Roof t'sl « Pitch Total Sq. Ft of Construction: IG�O I Sq: Ft: of First Floor: Cost of Construction: $ ;- 88-0y- utilities:'- Sewer — Septic Building Height: IVY" _ OUVN ER/I.ESSEE:• CONTRA Name &M& hEle na Name: Company: Address:�02Z_ r l4tJ City: �i =Pf..� State:C� Address: 3�-1 x - � City: Vt.- fcf�u State: G Zip Code: N-gYj Fax: Phone No. Zip Code: 'gcE°t fi'Z. Fax: 77 Z q to l-falt{s Phone No J7Z E-Mail: Fill in fee simple Title Holder on next 'page ( if different E-Mail from the Owner listed above) State or County License p0, -r-0 S'i3 f L©2 If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: Not Applicable _ Name:. Ae-64v TFsr_ AddressrlFr�;r� dv� City: V-V p�. State: a�.,,r.'. Zip:. 34OS-72 Phone 1Z,)- cl(an -z-)si FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: E COMPANY:' " - got Applicable Name: Address-_ City.- State: Zip: Phone: BONDING COMPANY: Not Applicable Name:_ Address: City:_ 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` will 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 osted on the jobsite before the first inspeguay. If you intend to obtain financing, consult with lender a ttorney before commencing workmf recibrding vour Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF The for offing instr nt was acknowledged efore. m this _J day of 20 �Tby j.w A / �A 1� Al h AIM 1% i• . I 2 -- s Name of person making statem Personally Known �� OR Produced I Type of Identification Produced (Si ature of Nota ublic- State of Florida ) Commission No. (Seal) REVIEWS FRONT COUNTER DATE RECEIVED DATE COMPLETED Signature of Contractor/License Holder STATE OF FLOF&DA COUNTY OF - 7 . ; TFie forgoing inst me as acknowledged for r(�s o this � day of 20�y a 9� ' m� Name of person making statement. o>� OA Personally Known OR Produced Identificat Type of Identification Produced ' &. a. Z� �L, A, (Signature of Not Public- State of Florida ) Commission No. (Seal) ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW