Loading...
HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APII LICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ►'' Date', 17 Permit Number: ' l I i l Tfay{�gQ�y�9�P�� 'F E:1� . E 1Ntl V VL'!! sYJ @r.:� Y 6r :gym ..cc. r� Y MAY 17 2017 a afh?Permit lication PcR,IG Plann, g and Development Services ", 6W St. Lucie County, F!_ Buildi'i g and Code Regulation Division �. 2300 it irginia Avenue, Fort Pierce FL 34982 r r= Phonlul : (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: II PRO ' OSED I�NPROVEM'ENT L®'C TION: Address: $ SO rl d Legal DI scription: %,��%���"(" lid/� a ��.� ,Propellliy Tax ID #: 4z1�2loQ 3 ©00 SIi0o� Lot No. Site PI Name: 5rd�PA!F10 �r��� Block No. Project Name: i SetbaGl s Front w Back: Right Side: A Left Side: --• Ii U illy n � r l� Ilrl CON'STR CTION I INFOR+MATI'ON: Additi(, rktobeperformed under this permit— check all that apply: _ I lechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors IIIII ectric Plumbing _ Sprinklers _ Generator _ Roof Pitch _ Total S _ '. Ft of Construction: > J�C) Sq. Ft. of First Floor: Cost of Fonstruction: $ _ �bd Utilities: _Sewer _Septic Building Height: ®WN'ER/LE�S�SE CONTRACTOR: Ja AI--S%14MM JfC Name: Name Addr I' s: �rOCA S'a <"I S 7— Company: CitN 87 8,; r— State: Address: Zip CI de: 3V5l �% Fax: City: State: Pho 14; y%4� Zip Code: Fax: E-Mail :�.1o�it/N 1%S?�! �S!� ~M F�`' Phone No fill it! ee Simple Title Holder on next page (if different E-Mail , l he Owner listed above) State or County License Lvalmue��"Iof construction is 2500 or more, a RECORDED Notice of Commencement is required. Name:_ Address: City: Zip: ENGINEER: Phon Not Applicable State: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: _ Not Applicabl Name: Add r-.ess: -< City: State: _ 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. 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 n'on' 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. I Intend to "Obtain financing, consult with lender -or an attorney before commencing work„or re,�bur Notice of Commencement. Sig natu fir e'�9t'otAgent for Owner ST OF FLORID COUNTY OF The forgoing instr ment was acknowledged before me this _.Z day of 20a by _-, V V 1, � �A Rw('a (Name of person acknowledging ) (Signature of Notary Public- State of Florida ) / Personally Known OR Produced Identification ✓ Type of Identification Produced """"". KAREN S. NI Commission No. _ e _¢ .. Commission # FF My Commission ��P� June 12, 2 REVIEWSr FRONT ZONING COUNTER REVIEW DATE RECEIVED DATE COMPLETED ev. Signature of Contractor/License Holder STATE -OF FLORIDA ,COUNTY OF The forgoing instrument was acknowledged before me this day of , 20_ by (Name of person acknowledging ) (Signature of Notary Public- State of Florida ) Personally Known OR Produced Identification Type of Identification �so�trrGE. LSEN 'xC' minis on No: (Seal) 18 " SUPERVISOR I PLANS I VEGETATION REVIEW REVIEW REVIEW . SEA TURTLE ' 'MANGROVE REVIEW REVIEW