Loading...
HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONdJ . All APPLICABLE INFO MUST BE COMPLEY— u ''FOR APPLICATION TO BE ACCEPTED Dateal `� �1 Permit Number: �1LW' RECEIVED Building Permit ApplicationAUG 17 2018 Plano �ng and Development services Builds g and Code Regulation Division ST. Lucie county; Porml;;Vng 2300 irginia Avenue, Fort Pierce FL 34982 Phone11 : : (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERK IT APPLICATION FOR: •\o�By��1 Addresll$: l 39J S`cry Legal Clescription: n Properly Tax ID #: '? 1 S Lot No. Site Pia n Name: Block No. Project Name: Setbaj s Front Back: Right Side: Left Side: a e Addltl, nal work to be pertormeci under tnis permit — cnecK aii tnat apply: GI echanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total S'� . Ft of Construction: Sq. Ft. of First Floor: Cost o('Construction: $ ( 9,00, ©a Utilities: _Sewer -Septic Building Height: ©WN'ER/LEIS SEE: CONTRACTOR: Nam'p Address: City. Zip C Phonlll E-Ma Fill in from I 0 .'Name:;•.:,. _ 'Company: ({ `a$'�99 2, Stater de:-'? Fax: No. IZ, 12sS!A 06 Q't ` Address: ' City: State: Zip Code: Fax: 'Phone No E-Mail =�4,o1�?�u Q 9y V,L000 n it?, _ • ,;.i,. fee simple Title Holder on next page ( if different ffie Owner listed above) State or County License If valuelfof construction is 2500 or more, a RECORDED'Notice of Commencement is required. Sl1PPLEMENTAL CQI-SITI&M WT URNA U'ENI 1A. M INF+ RMATION. DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: �I FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicabl Name: Name: Address: Address: - City: City: Zip: Phone: Zipal 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 structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. such 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 i before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. Signature of Ow r/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OF STATE OF FLORIDA COUNTY'OF The forgoing instrument was acknowledged before me this day of Jq . 20� by The forgoing instrument was acknowledged before me this day of 120 by w%%c R w-` (Name of person acknowledging) (Name of person acknowledging ) i (Signature of NotaWl Public- State of Florida) (Signature of Notary Public- State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced 'V JbL_ DNAMARIE GIVENS ""••'••• N # GG 022023 Commission No. �.5 ''' * M �De%ember'10020 IR NbtaN Public Undent m1e <: I'hrU Type of Identification Produced Commission No. (Seal) - - REVIEWS FRON ZONING SUPERVISOR PLANS VEGETATION SEATURTLE I'I MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIqW DATE 01 L 1 e) i RECEIVED DATE COMPLETED ev.