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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAllII IPPLICAB E INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / Permit Number: AQ If SCAN FM RECEIVED . T, BY St, Lucie Cou J U L 0 2 2�J18 s Building Permit Applica 5`+"LUcie County, Permitting Planning and Development Services 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: S,a\0 `Y Description: 04LeaY) Pg!7zo _5' -4 L10$2(;,"'Y_'jj jertyTaxlD#: Plan Name: ect Name: I !e rV- Al a ✓) backs Front 1 7, oQ f Back: 20 Right Side: :` Left Side: , 19. q ) Lot No. Block No. DETAILED K P,,RIPTIQNPaF WQRK e CONSTRUCTION INORIVIATION' _ _ iti 0 nPi work to be per orme s un er-t is permit -.checkall t at app y: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Electric _ Plumbing _ Sprinklers generator — Roof Pitch otal Sq. Ft of Construction: '<�Yo(-_) Sq. Ft. of First Floor: ;ost of Construction: $ D-9G G Utilities: —Sewer —Septic Building Height: OWN 1 : z �.... O ,1= :! f. i�llt'I i;l �i)J r SIEI;Ib •'I� � Cd/y C i�7f� �e �d�; �,,� Name: At n9c.,,. .,. C�om`p�an�':11 � c 4,:� ;''r r c'., e n ,n Address" `c5 � 1 `� ' '' '� City: 1' r ,,r . State: r L nut, arxt��h--i 57" ,a V&I ` '% C, address:> c �ti. d; .,, • tl1..�1 r.,= n'% /, x. // ZipCode c _ :�'y Fax:c k�.'�, ;.`�:. City: �1=:� ,:�..;v.�;..�r...�-�,•�. ', G c �li�a.n Stater Phone No. � cN 6 •" /S)o 7 Zip Code: Phone No Fax: S' -'110 7 E-Mail: ,k ... n i aQ_'VC© O Fill in fee simple Title Holde on next page ( if different E-Mail � /yr LP/ U Q 4 C6rn from the Owner listed above) State or County License If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. �.`c`^ 1q S#PL11 IkL GUSTRICTiN:N NQV[AT% aH Yry � " DESIGNER/ENGINEER: _ Not Applicable .. .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 permrit 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 co.ncurrency 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. Signature Contractor/License F&er Signature of ner/ Lessee/Contractor as Agent for Owner of STATE OF FLO STATE OF COUNTY OF A�Qd`�v, \�e�t� COUNTY OF The f . oing instrument as acknowled ed before me this day of �. 2� by The f going instru ent acknowledge before me this day of 20 (Name of person acknowledging _, (Name of person knowledgin ` (Sign t Notary Public- of Florida) (Signatu f Notary Public- StaV Florida ) Personal y nown OR Produced Identification Personally Known Type of Identification Type of Identificatio KRYSTAL VAUGHN t`t+4 Produced KRYSTAL VAUGHN Produced :� NotaryPublic - State of Florida NOisry Public - State of FloFlda ? • . .. Commission N FF 997589 Commission No. 3• Co i FF"987589 " =., , M Comm Jun 12, 2020 Commission No. ,r �, y {lp� My Comm. Eaplrei Jun 12, 2020 Taiali Bonded through National Notary Assn. n w `. Bonded through National Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION"' SEATURTLE MANGROVE COUNTER REVIEW. REVIEW REVIEW REVIEW' REVIEW REVIEW DATE RECEIVED DATE COMPLETED ke—V.7/2-014