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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE I FO MUST BE COMPLE.��-,' FOR APPLICATION TO BE ACCEPTED Date: *'o � Permit Number: D� SCANNED BYSt. Lucie Counv -W Building Permit Ap ication Pldlnning and Development Services Bui ding and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Ph'Le: (772) 462-1553 Fax: (772) 462-1578 COfT1YYle1'CIaI Residential PEJ�MIT APPLICATION FOR: PROP®SED INPR©VEM'EN LOCATIt3 Address. �&s 49 Legal Description: Ar k k - O/1- r--;9N1wT L4,/0Ad. Property Tax ID #: ��'Z� a ox / e 'Lot No.� 'F- L1, /f?/ Block No: � /� Site Plan Name: 7�' �!Gd ul�- ,.-� lU /I/ i Projett Name: 17,eUX / &(l Setbacks Front �A Back: d1/ Right Side:/ Left Side: Total Cost c nai worK to oe pertormea unaer tnis permit - cnecK aii tnat apply: echanical _ Gas Tank _ Gas Piping _ Shutters lectric _ Plumbing _ Sprinklers _ Generator I. Ft of Construction: I 5C Sq. Ft. of First Floor: Gv Construction: $ Utilities: —Sewer _Septic _ Windows/Doors Roof Building Height: ir OWERE?SSEE• - w CONTRACTOR: Nam Name: Address: i 2/l/(!G = �afC Company. Address: City: State: State: 1/ Zip C de: 677: � Fax: City: � � State: / Phon� No. 77Z "4Q8 02P) Zip Code: % Fax: Phone No E-Mai• � f�" ey`7.iW Fill in'Ifee simple Title Holder on next page' (if different E-Mail -2-s Z176 <2— �' �°1��4 Sf , Neel' State or County License 4�1!66 - OZ/3-8 0 from the Owner listed above) If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. Sr1J�P-pLEMEN' 1. C{3 S�TR+ ��T aN LIEN LAW "NFaRIUTAI't0 DESIGNER/ENGINEER: Name: )S---*/L Cd4/e— _ Not Applicable AM MORTGAGE COMPANY: Not Applicable Name: Address: Address:: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: 1 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 l 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 impro ements to our property. A Notice of Commencement must be rec rded and posted on the jobsite befor the em first iry pection. If you intend to obtain financing, c nsult with�nder or an attorney before comll{�fiiencing w k or recording your Notice of Commence t. / of Owner/ Lessee/Agent Signature of Contractor/License Holder STATE OF FLORID STATE OF FLORID �/� COUNTY OF : COUNTY OF T� The fo g ing instru e t a acknowledge fore me this day of 20 l by (Nailine of person acknowledgingPq- An=� (Signature of Notary Public- Statb of Florida) / Personally Known Type of Identi Produced Commission No. OR Produced Identification DAWN MILDNe ry((g�bl; -State of Florida MyNota6b0'%, � pins Mar 2.2, 2017 Commission # Et'877571 The forging instrum �t was acknowledged before me this // day of 20`by (Name of person acknowledging) (Signature of Notary Public- State of Florida ) Personally Known R Produced Identification Type of Identifi ati Produced -� ' ��""�` ` Mkt`' NUNI Y PU1311Ltare ,i rorida • : �' Y Ia4. 7omm. Expire�Q' ar �j2, 2017 Commission No :N *, _ - Gemmission # €� 11571 Bonded Through National Notary Assn ' , REVIEWS FR NING SUPERVISOR PLANS VEG T/�TION" ` "-S-E-A-TURTLE,-, ,.MANGROVE COUNTER REVIEW REVI REVIEW R 1 'a `. ;< EVIEWY MU � REVIEW , N , DATE Q ° ;` _' = ''�,FOFF�O rat My Corm" ExPi,es •1 .rr. 1 RECEIVED v kz hi, Comm"'Z 2, 20 17 DATE onded ihrou 9'COMPLETED 110f1 `