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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi ALL A rPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED DatE SCANNED Permit Number: 10Ub (l ! (w 7Buin L' ju Q U RECEIVED �t. Lade Countv Building Permit Application AUG ®8 2017 Development Services Permltting Department St,LYCIe County Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Pho I e: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PER IT APPLICATION FOR: To Select from dropbox, click arrow at the end of line ;PRO ;OSED IMPROVEMENT kOCATlON - Addre s: qQ oyA ,RA o9_9. Legal I escription: 1111c,,O /u;-/"yic 4_14-4x A 7 , i/�.Y !;AZA - 294144 4o7" % a Prope y Tax ID #: J� S-/did /0 Lot No. / Z Site Plan Name: Block No. AX Proje Name: Setba ks Front Back: Right Side: Left Side: DE T [LEDDESCRIPTION OF`WO.RK:' )2,&a, /Ac1Z Tv Z f/�-3v ✓fL tGv �,� %'2/wc,a wiz / .;1,we- CONSTRUCTION INFORMATION: Addit5na wor tobenerformed un er t is permit— c ec al apply: ❑ VAC Gas Tank Gas Piping _ Shutters ❑ Windows/Doors ❑ LI" lectric Plumbing ❑Sprinklers ❑ Generator ❑ Roof Roof pitch TotalI q. Ft of Construction: L2 7 9 S Ft. of First Floor: %! JG Cost 0 Construction: $ S CyU Utilities.- _Sewer ❑Septic Building Height: OW DER/.LESSEE;_` CONTRACT R: Namel Addre City: Zip C Phone E-Ma Fill in from I 5V5AL1_ T, ` —120S /Z Name: Company: ire s: r1' 0 Q &I.A !2>Z ,i211 P 4ti./� State: �L de: ,; SF S-7 Fax: .t:/p No._ 7/ - ©e 4;nt Address: /"? C? ;Jcair 132 City: T, SA/y ,��,L /f State: %�L Zip Code: 37c9S Fax: T7L-3JSd � ►� Phone No, 404 iee simple Title Holder on next page (if different a Owner listed above) E-Mail: Ro51,.) State or County License: If valu$lof construction is $2500 or more, a RECORDED Notice of Commencement is required. SOPLEMENTAL CONSTRUCTION LIEN..LAW INFORMATION: ; DESIGNER/ENGINEER: Narr Add City. Zip: Not Applicable e: MORTGAGE COMPANY: _ Not Applicable Name: Address: ess: State: Phone City: State: Zip: Phone: FEE Na rT Add City Zip: §IMPLE TITLEHOLDER: _ Not Applicable i1e: BONDING COMPANY: _ of Applicable Name: ess: Address: City: Phone: Zip: Phone: OWN R/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I certi that no work or installation has commenced prior to the issuance of a permit. St. Luc County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such struct e. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In con deration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work in acc dance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The fo owing building permit applications are exempt from undergoing a full concurrency review: room additions, access ry structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WAR I ING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for impr ,ements to your property. A Notice of Commencement must be recorded and posted on the jobsite befor the first inspection. If you intend to obtain financing, consult with lender or an attorney before comniencing work or recording your Notice of Commencement. ] Sign ure of 0 er/ Lessee/Contractor gent for Owner Signature of Co tractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COL NTY OF S!-' WCA-e COUNTY OF Sd' The f )rgoing instrument was acknowledged before me The for oing instrument was acknowledged before me this -'I day of Pas,- , 20�y this -1 day of Aar- 20ff by CA S-1,� jam..,, t 214M KJ_. Name of p rson making statement Name of person making statement Personally Known OR Produced Identification _� Personally Known OR Produced Identification JL Typ 'of Identification Type of Identification Produced Produced �• I (Sigr ture of Notary Public- a of Florida) (Signature of Notary Public- State c6Frbrida ) Com ission No. (Seal)M:C-�'I-': Commission No. (Seal) 1, ��I I IINp �i� �•115 ����!RE IEWS FRONT ZONING 0 PLANS VEGETATION SEATURTLE MACOUNTER REVIEW REVIEW REVIEW REVIEW R IDATRECEIVED o=3yDAT aXCO jPLETED zooRev.8 /17 ;, TY'1v�0 Q 0 H v Q A _