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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll AAPPLICABLE INFO UST BE COM'NLtiED FOR APPLICATION TO BE ACCEPTED ' Date: Permit Number: /'/Z OS9�a Building Permit Application PY, Planing and Development Services Bui ding and Code Regulation Division / 23 �0 Virginia Avenue, Fort Pierce FL 34982 / Ph ne: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PE,�MIT APPLICATION FOR: -1760& �Ct� "I Legal Description: "IS 6 t7- f CC_:;�15V 4.01 L,G epV / . , Pro pllll rty Tax ID #: (560 1 — n (bb - -7 Lot No. Site Ian Name: Block No. Proj liAct Name: /4/L-C Setl1iacks Front Back: Right Side: Left Side: IU Al Add tional work to be pertormed under this permit - check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters 1 Electric _ Plumbing _ Sprinklers _ Generator Tota Sq. Ft of Construction: Cost f Construction: $ l ?Cc _ C:Y, Sq. Ft. of First Floor: _ Utilities: —Sewer —Septic Windows/Doors _ Roof Pitch Building Height: ©UVN@10LET=-S EE: CONTRACTOR: Na Address: City: Zipj PhoIlne E-M' Fill fro ne-: Name: 37n7 ,� 1r1 Company:.'- 4`' 7 l� �c r�� State: rZ Code: Fax: No. 7 Z/(, Ad&es' 76 L � =Z City: l State: Yq- Zip Code: _3.90i Fax: A Phone No / 'WV &/O / -Z� ail: S/7aaLc- 666 i,) Rdylri-It Corte in fee simple Title Holder on next page ( if different the Owner listed above) E-Mail -z State or County,Lice�lse',t 0?J� If val 1'e of construction is 2500 or more, a RECORDED Notice of Commencement!„ re4uired: jt III 1 f' -- i t F'PL N AL G0 S R�uk C1 !I �N WIN"CORM t0 DESIGNER/ENGINEER: Name: Address: City: Zip: Phone Not Applicable State: MORTGAGE COMPANY: Name: Address: City:. Zip: Phone: 4.z4ot Applicable' State: I FEE SIMPLE TITLE HOLDER: Name: Address: _ Not Applicable BONDING COMPANY: Name: - of Applicable Address: 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 for improvements to your property. A Notice of Commencement must be recorde and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with I or an attorney before commencir�o-k or recording vour Notice of Commencement. Sign9eur9v6f Owner/ Lessee/Contractor as Agent for Owner . I Signature of,126pt`ractor/License Holder STATE OF FLORIDA I I STATE GF FLORIDA, COUNTY OF du �!�• COUNTY OF Jj 1,& Uri ZyIY, The `for'g�oing instrument w acknowledged before me this `i�1 day of 2018 by rson of Notary P6blic- §tate of Florida ) Personally Known )L--J_ OR Produced Identification Type of Identification Produced � °ai, JESSICALANIER �N* MY COMMISSION # GG I } aI�24 PIRES:Febwry, 9, Foy F%P Bonded ThM Budget Notary Commission No.0 REVIEWS FRONT ZONING COUNTER REVIEW DATE RECEIVED DATE COMPLETED The forgoing instru nt wa cknowledged before me this f day of 20 [8 by v Personally Known OR Produced Identification Type of Identification o.�0yNe, JESSICALANIER 'Produced * *MYCOMMISSION#GGI Q_ PIRES: February24, Commission No. 9'Fo F I TM Budget Notary SUPERVISOR I PLAN VEGETATION I SEATURTLE I MANGROVE REVIEW I REVI REVIEW . REVIEW REVIEW 9Ily /it, t ).