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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED °. Date: 9--��- Permit Nu . SCANNED F ' i sly {fs o a SEP 12 2018 - Building Permit App iR"m Ring Department Plannil g and Development Services St. Lucie Co U n j-y FL Building and Code Regulation Division __ ___ ��. 2300 tIirginia Avenue, Fort Pierce FL 34982 �. Phone (772) 462-1553 Fax: (172) 462-1578 Commercial Residential PERIT APPLICATION FOR: RC3P�� SED ULU!& 1lEMENI' 0 ATIONt Add res : `� I (7 VIN A--,) Legal Dllscription: Prope Tax ID #: ����„C, '"' (� ©� �ji�� — Lot No. Site Pla i Name: Block No. Project Name: Setbac is Front Back: Right Side:_ Left Side:_ D T FLED DE�SCRI�P'TION OF WORK: wre- lea ton, o CON TR'U�TION lNfORMATION: iti na work to a per orme under this perRIM mit - check a that apply: _ echanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors lectric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: 3 Sq. Ft. of First Floor: Cost of � hh � Construction: $ d Q� " Utilities: _ Sewer _ Septic Building Height: OWNER/LE10SEE: CO IIRAC 10R: Name: Named M14), d V%Ck Address:_p�-� O {p«.� 4,6 �y Company: '>r•t. pt, xy_- %G State: Address: City: City: State: Zip Code: II 349 8 a- Fax: Phon I No. 7 a " 3_1 r Zip Code: Fax: 4YLCP.1 a.t C-610L E-Mai Phone No E-Mail Fill in Ifee simple Title Holder on next page ( if different the State or County License from Owner listed above) If value if construction is 2500 or more, a RECORDED Notice of Commencement is required. PPCEM �NT CQNSTRUCTIO LIEN NFi3RM Tl • N: DESIGNER/ENGINEE _ Not Applicable MORTGAGE COMPANY: Not Applicable Name: a ^ , _ "Name: Address: of b '► 9a F 11 Address: City: N State: �L— . City: State: Zip: -T Phone Lk-1 5 3g .— V 353 Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable 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 for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording your Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF C I STATE OF FLORIDA COUNTY OFORIDA \ L COUNTY OF The fppr oing instru ent was acknowledg before me The forgoing instrument was acknowledged before me this Iday of 2010 by this day of 20_ by �\CL�A • W �n Na making statement. Name of person making statement. Personally Known, ti ._ �0Pr d ce. I entification I Personally Known OR Produced Identification �I on��.,aYp. kl" & 1,,,�, ANGELA M HUFF Type of Identification I' Produced ,' r���1�. Notary Public _State of Florida Produced 1. Commission # FF 234730 My Comm. Expires May 27, 2019 `!Nary Assn. (Signature of Notary Public- State of Florida) r "' (Signature of Notary Public- State of Florida ) Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGIROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17