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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll PLICABLE INFO MUST BE COWFLETED FOR APPLICATION TO BE ACCEPTETt)(0D 1 _0 E �O �` •� Permit Number: CANNED BY RECEIVED Ste Lucie county JUN 2 9 2018 Building Permit Applicatio inn and npvalnnmant S?rvirPS ST. Lucie County, Permittinn Bu�1Wing 2311I Ph and Code Regulation Division 0 Virginia Avenue, Fort Pierce FL 34982 Ipne:.(772) 462-1553 Fax: (772) 462-1578 Commercial Residential II, PERMIT . APPLICATION FOR: P'F�®POSfD IMPROVEMENT LOCATI®N: Address: Leg I'I Description: _ . �1I _ . _ & 4 1_1 -1 G/— Al V V — A % "I ry A I r l U ICI Ly 1 pn I V ft. - ./\ Ot. ,C/.J ✓ V r/ !/ / (.r / E.,I ..v .. ..v. Site Plan Name: // Block No. Project ct Name: Setbacks Front Back: Right Side: Left Side: fl 4�)/ C :tonal worK to be perrormea unaer tnis permit— cnecK an tnat apply: Mechanical _ Gas Tank _ Gas Piping _ Shutters. _ Windows/Doors Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Sq. Ft of Construction: )f Construction: $ Sq. Ft. of First Floor: Utilities: —Sewer —Septic Building Height: 01NN1R,%LE=-SSEE: CONTRA OR: Na' Ad' City/'�sce Zi Ph E-N Fill from i e�t�?f ioi� /Y% ��n�P�`� Name: .�e�� I ress: i9�5���/ Alk�m e,4- /h_ Company: State:_ Code: !L? V% k_l Fax: No. 0 7-a_:V7- 7S'!9z Address:, City: State: Zip Code: Fax: Phone No Ine lail: be in fee simple Title Holder on next page ( if different the Owner listed above) E-Mail State or County License If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMEN AL CCiNSTRUCTIQN LIEN LAW IN �QRMATI©N: DESIGNER/ENGINEER: _ Not Applicable Name:ms MORTGAGE COMPANY: _ Not Applicable -Name: Address:& City:.. State` Zip: Phone Address: City: State: l Zip: Phone: !I FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: 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. I St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure) I 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 i 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 coricurrency 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 our Notice of Commencement. ,5 ri nrew Ownerr/sL•essee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORID �. STATE OF FLORIDA COUNTY OF (i, I� . COUNTY OF The f^orgjoing instru ent was acknowledge efore me The forgoing instrument was acknowledged before me i this � day of 20by mfiznkk this day of 20_ by (Name of person acknowledging) X R - �Lxc___ (Name of person acknowledging- ) (Signatof Notary Public- State of Florida) (Signature of Notary Public- State,,of Florida ) Personally Known OR Produced Identification ✓/ Personally Known OR Produced Identification Type of Identifi 'on Type of Identification Produced roduced o•;oJo'�8,, KAREN S. NIELSEN Sx° 0s:State gfl�Florida-Notary Publ Commission No. =• C ssion # GG 207484 c ommission No. (Seal) %h`CP My commission Expires -+ June 12, qn99 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE 4MANGROVk COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED II DATE COMPLETED ev.