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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONWo Addre CABLE INFO MUST BE COMPLETED I --.'APPLICATION TO BE ACCEPTED Permit Number: ing and Development Services ng and Code Regulation Division Virginia Avenue, Fort Pierce FL 34982 e: (772) 462-1553 Fax: (772) 462-1578 'vim n flapI RECEIVED ruA1fd7n -fP'e�i�°mit Application JUL 2 6 2910 Ir I� Permlttfng Department St. L.UCIn �-n nw Commercial Residential MIT APPLICATION FOR: Eno .dk4 Legal Dlil scription: �� V 0:2, PP-. K NIT 13L�K b tY E LP 34 /22-S Og, 30-15 - 250Z) Propert l Tax lD #: 4 19 S O I OO --1 (p O©(2(o Lot No. Site Pla (Name: Block No. Project ame: Setback Front Back: '—! 3 Right Side: Left Side: Atloitmnal orK to oe perrormea unaer tnis permit— cnecK aii tnat apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ ElectrL _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft o' Construction: a4bd, eb$ Sq. Ft. of First Floor: st of Constluction: $ 5Z1O0 , a d Utilities: —Sewer —Septic Building Height: OWNER/ E-�SSEE: CONTRA OR: Name U Name: Address: Company: Address: City: PS U, State.. r Zip Code: l Fax: Phone No. I E-Mail: Fill in fee simp a Title Holder on next page ( if different from the Own listed above) City: State: Zip Code: Fax: Phone No E-Mail State or County License If value of const*u ilon is 2500 or more, a RECORDED Notice of Commencement is required. SUPPtEMEN AL CONSTRUCTION LIEN LAW I FORMATI©N: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: of Applicable Name: Name: Address: -Address: I City: State: City: State: I Zip: Phone Zip: Phone: .I FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: of Applicable j Name: Name: Address:. Address: i 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 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 fog improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before tiMfirst inspection If you in nd to obtain financing, consult,with lender or an attorney before comme ci or re4oW44,y6ur Notice of Commencement. �UV I Signature of wne Lessee/ ntractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORID 5 �Z�e STATE OF FLORIDA COUNTY OF k- COUNTY OF The forgoing instru nt wa acknowledged before me The forgoing instrument was acknowledged before me thi;a5 day of V4 20_ by this day of 20_ by n making statemen Name o/entification Name of person making statement. Persohwn OR Produ ed Identification I Personally Known OR Produced Identification Type of Type of Identification Produc Produced (Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida ) Commission No: (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW (3EVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED r , Rev. 8/2/17 NER/ENGINEER: A aress: Ci'�; State: Zi ',: Phone SIMPLE TITLE HOLDER: _ Not Applicable ress: Phone: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: Not Applicable Name: Address: City: Zip: Phone: OW � ER/ 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. Lu�ie County makes no representation that is granting a permit will authorize'the permit holder to build the subject structure whicf}� is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such . stru rre. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In co 'Sideration of the granting of this requested permit, I do hereby agree that Twill, in all respects, perform the work in ac ordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The f 11Ilowing building permit applications are exempt from undergoing a full concurrency review: room additions, acces i ry structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WA INING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for impr i vements to your property. A Notice of Commencement must be recorded and,posted on the jobsite befo 'e the first inspection. If you intend to obtain financing, consult with lender or an attorney before Amm .u­L ^r rnrnrrlintirck of rnmmPnrPmPnt. wnn ,1c1ia113Ivvwe ............ ..... ....�.... _. I� __......- -- - - Sign ture of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STA E OF FLORIDA STATE OF FLORIDA CO NTY OF — L�c.J C .: COUNTY OF The I rgoing instrument was acknowledged efore me The forgoing instrument was acknowledged before me this day of . 26 by this day of. . 20. by r Nam of person making statement. Name of person making statement. Persdnnally Known OR Produced Identification � Personally Known OR Produced Identification Type ', f Identification Type of Identification Prod ced Produced (Sign 'ture of Notary Public- State Florida) (Signature of Notary Public- State of Florida ) Com fission No. (Seal) '$�5. "All ommission No. (Seal) ' REVIEWS FRONT ZONING SUP Cn VI$OIE LANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REi3 3 a VIEW REVIEW REVIEW REVIEW DATE' 3 RECEI ED aCo m _. DATE 'I . c, COM LETED (Di o ev. y N c 0 g �Qo