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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABL INFO MUST BE COMPL'i` i) FOR APPLICATION TO BE ACCEPTED 0v��� DaPermit N , r x OCT 01 2018 Building Permit Ap Ps 'i g Department PlanniS ing and Development Services E® St. Lucie Cuun FL Building and Code Regulation Division BY r 2300 I�irginia Avenue, Fort Pierce FL 34982 St Lucie C®urty Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: Address: ! U n k S IJJ-r-t4 TA Legal Description: I+EFC7�py-,l i 3 cue k_2T 3e LY6- C i% e ly Rom' Ph.. 2_1 Property Tax ID #: Z. 1�i ' b��� �O(� �• Lot No. Site Pla,k Name: Block No. Project�Name: 'qz�?E Setbacks Front Back: Right Side: Left Side: Total S Cost of i f ai worK to oe perrormea unaer tnis permit— cnecK aii tnat apply: chanical _ Gas Tank _ Gas Piping _ Shutters ctric _ Plumbing Sprinklers _ Generator . Ft of Construction: Sq. Ft. of First Floor: instruction: $ — I '�© Utilities: —Sewer _ Septic Windows/Doors Roof Pitch Building Height: C 1I1�N� R/I� k54, +CC+3NTRA Name i' Name: r tLUA-e 2 �� Address: �JC� �% f 4tk D11, Company: City: \ !✓l State: �7 . Address: Zip Code: ?5�. Fax: City: State: Phone !No.'. G\ — -7.3Z� Zip Code: Fax: E-Mail: 1r�(%V2.a�iA-Q �e�' 10)��c%' ) (��`h) Phone No Fill in f a simple Title Holder on next page ( if different E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. Y DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: Stater 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. 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 allrresp'ects, 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 ndn-residential use WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in youi: 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 financin ,'consult with lender or an attorney before commencing work or recording your Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent.for Ow Signature of Contractor/.License Holder STATE OF FLORIDA-- : • STATE OF FLORIDA OF COUNTY OF COUNTY The forgoing instrument was acknowledged before me this day 20jg� by The forgoing instrument was acknowledged before me day 20_ by _6J of � �.,-�— this of 2m"i r 2 Name of person(making statement. Name of person making statement. Personally Known OR. Produced Identification Personally Known OR Produced Identification Type of Identification tt ��. 0111ito®ii' Produced I �,0 1-, A) ��o Type of Identification Produced � � boo 6•,°......e�/y�' o�AR (S' ure of otaryPub ic- tate Flo wOomm' JUIle 13, 2020 g Signature of Notary Public- State of Florida ) r' �� ?- FF 991988 Q Commission No. �, -- (� -(� e) �,COmmISSIOn No. (Seal)- REVIEWS FRONT ZONING�4$ �� f Fj�13bR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED , Rev. 8/2/17