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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll PPLICABLEjINFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u Dllte: tit l �� Permit Number: BY RECEIVE® a. Lucie COU`01 - . - - JUL I O Z018 Building Permit Application Pith ning and Development Services S'�. Lucie County, Permitting Building and Code Regulation Division 23, �0 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential_ PEWIT FOR: PROPOSED lNPROVE(UIENT LWCATIO'N: MASS: ss: 2-1 `S5.I1.2'Y1 C7-r P14l�f-E Legal Description: Propeil y Tax ID #: �1�i 1 •, (bq:- t o — fit)r) --:7 Lot No. Site Plan Name: Block No. Projed Name: Setbaiiks Front Back: Right Side: Left Side: DETALLED D�E�SCRIPTlON OF WORK: V D i C�ONSTR�[1CTIO�N I1NF©R+107, ATIQW1: itiTa work to be performed under this permit- check all that app y. Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator �oof Pitch Total Sql Ft of Construction: �P Sq. Ft. of First Floor: Cost of CII nstruction: $ Utilities: —Sewer _Septic Building Height: OWN =R/LE=-S�SEE: CONTRACTOR: Name 7. (�U Name: ri11� Addres�l: W % C "S p� a YLGt'�i� - �• Company: Address: City: r� 19 1A 4t Stater City: State: Zip Co �I : Z Fax: Phone o. .2 Zi Code: Fax: p I E-Mail: I Phone No Fill in a simple Title Holder on next age ( if different E-Mail from thlOwner listed above) State or County License If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. �llPPi_EM NTAL Ca ST � �U TiC�}N LPEN i.AW !'N�Q'RMA ON. DESIGNER/ENGINEER: _ Not Applicable Name: Address: City: State: Zip: Phone MORTGAGE COMPANY: _ Not Applicable Name: - Address: City:. " ' State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: BONDING COMPANY: Not Applicable Name: Address: 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 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 your Notice of Commencement. rJ 4&/Z�,t S& 1,07�- atureq Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLOTDA STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this is_ day of _ u 1 v 120 1 by this day of 20_ by -0 Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced L 1D 1. Produced r (Signature of Notary _ Eifr°�SYa of[F1bF1Iftan� N#GOpz-023 x� (Signature of Notary Public- State of Florida ) �. �'' •: s MY COidIM1s reM 2020 Commission No. M4t? ¢. EXF of PuhllcUndenNd1ets 5 pia() i Commission No. Sea'I/ d REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 8/2/17