Loading...
HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI All APPLICABLE INFO MUST BE COME`.'" i'ED FOR APPLICATION TO BE ACCEPTED Date: /oillif, Permit Number: 1810 —0003 Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: RECEIVED OCT."O 1 2018 Building Permit Application Permitting De St. Lucie partment County Commercial Residential Addres�: 17& DI 5E3 A sr/ r9 nJ 8.8 E r. f i c--ncz, EL. 3 4 Q �s/ �vueea� Legal Description: 13401 00014 i Propel iy Tax lD #: /,3O/— (00 of —D / "-- (000114 Lot No. Site Plan Name: Block No. Project]Name: Setbacks Front Back: Right Side: Left Side: Aaani inai worK to De perrormea unc _Mechanical _ Gas Tank Electric _ Plumbing Total Sq. Ft of Construction: Cost of (Construction: $ % oo C7 L Le is permit —cnecK all that apply: Gas Piping _ Shutters Windows/Doors Sprinklers _ Generator Roof Pitch Sq. Ft. of First Floor: Utilities: Sewer _ Septic Building Height: 110,W111 NER/ ERSSCE: ©NTRACTO Name eoj d'. 'S._ F}Rck e.-L_L Name•' Company,' Address: 3 -3 6 ,%. Ln.-I-e_ 'SiTls--e-4 City: I cA)tl�S i E� Stater) ` Address'." Zip Code: ✓) 6 U 9 Fax: - City: - - -' ` State: Phone) No. S60 — 415(� — 4 Zip Code: Fax: E-Mail: %1_1*r_qe,c h _LL. Phone No E-Mail Fill in fee simple Title Holder on next page ( if different State or County License from the Owner listed above) If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: 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. ; A, 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 fors . improvements to your property. A Notice of Commencement must be recorded and posted on the jobsife 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 Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF 1 The forgoing instru as acknowledge befor a _... The forgoing instrument was acknowledged before me this J_ day of 20 by this day of 20_ by M411I (Name of p rso acknowled 'ng) (Name of person acknowledging) _ QQ �O i (Signature of taryPublic-State of FI rida) (Signature of Notary Public- State of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Ide ica io Type of Identification Produced Produced Commission No. )l �,��Par'd�MSUPERVISOR . No. (Seal) = 4''�o„�o�nnmaREVIEWS FRONT ZONING VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 7/2014