Loading...
HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLIII ABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I� \ d a � �I %0 Permit Number: Date: 1 11 RECEIVED y Building Permit Applicatio sEP 2 5 , �$ Planninc and Development Services ST. Lucie County, permitting_ Building land Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: �111772) 462-1553 Fax: (772) 462-1578 Commercial Residential ;✓ PERMIT APPLICATION FOR: S` a t CAN11E1 PRO;PCISED 1NPRQWE SENT LtJC T1aN: Address: ' 9.5-51 RI d.d eve. A Legal De lco� ription:�� � �1��r�fwfes Ctcc�r�(+ ,� f� `fez % i Soo k (.7 p� 2. oX Kc LL eeoe-ds o4- Sfi. LLe�,c ('�,. F/0k «(� Property n �r Tax ID #: 23�� 10 00 1 "1 © CC, Lot No. 4 Site Plan Name: F (+ c4 ek r Block No. 8 Project ame: Setback Ri ht Si e: Left Side: f `�c Front `3e� Back: gLIETAED JL D���C 1�P1'IC1 QF V1/C►RK s a l l 25 Z_ k „ f= - S i'^✓ Q Y`5 , `-ps 1-- 1=L' 4k h e O 0 e l L C l o S GL. Y�E , IZrr fki'cL ho /C-gS 'f4 arm 3C7tl0 12 Sr'Add CONST UCTION 1�N '0R{MATI©N: itio 11[] al work to be pertormed under this permit -check all t at•app y: ✓M Ichanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of c nstruction: $_ l go o Utilities: —Sewer —Septic Building Height: OWNi b I _R, I 11RMNffiRACTOR. Name: c 1 rc'; (e_. M ►3 f-'c�k_' rg_ve-s T-Ke. Name 11 Detlev --F(' 5z4_LLe'— Addresii: S�Qi l %��"ad�.� 1pities i2dL CompanyS City: F0}4- j'; e rc,e State: L Address: 15828 92 mot Wcu., A4 City: SGLI2 c` f'�►-- State: PL- Zip Cori e: (0 34- H Fax: Phone No. ) - 925 - q22 - 0356) Zip Code: 33+78 Fax: det (e V@ fi SZa �.¢�er- a Ca7►v� E-Mail Phone No ( 561, 57S - 03 00 Fill in fie simple Title Holder on next page ( if different E-Mail �rnLrn b`-� c 1z hswers @ �r.a i `* .ca vet from the Owner listed above) State or County License If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUppL AMEN .A Ca STRU Tlto}N IIE W IN'F4RMATIO . 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 Applicable Name: Name: Address: 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. I 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 Aont for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of 20_ by this ' day of 20_ by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida ) Personally Known OR'Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PAN VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW VIE REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED 61 KOO(,� ev.