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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION� I I -vr ALL APPLICABLE INFO MUST BE COMPI. ETEB IF VED E ACCEPTED l� Date: — b Permit Number: I� _ lo 1� OCT 19 2018 . � ST, W& Ogunty, Pprmlt: 1p dt,u4luajad.;A3uno:) aion� 1S Building Permit pp ication SioZ 6 1130 Planning and Development Services Building and Code Regulation Division 12300 Virginia Avenue, Fort Pierce FL 34982 (Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: Fence # „r� �>LiTt� :: � � � ♦ T °�Y tw ai•'•(, {>, sv�mb,+''s°.. -_ _ _ �K �� �%��� IZ Z `� Z�J loc,k- jo� 711AJ 7(-) Prloperty Tax ID #: l 1 Lot No.2I— Z 3 Site I Plan Name: A Block No. Project Name: Setbacks f ' Fron4 lsr Back: Right Side Left Side- T.�.:��*v�h`Src+�,`s%-,�5�','�`iiNta. .'a$:Y.'iti�,�air.i'+i=; �,. ..e '�,�,,.iF,"4 'a.A+P.¢4,,, i., •�rf»£...., kf'idrr•'�"��:Y.,,,, �>i,. �38A s�,';,'P ri�'<o't£>s.h„�.". ,.'?�'i:^tE.,*i�nl ?>Pa.... --I" is t': ds _ Ca- SCANNED SY CGA11�1i5 St Lucie County "➢id'.k,:;£� Additionalwork ad S q�f^. ;s NINE,, �, d' NOR,' '� �. i s ''vx, :, „ .'.. to be nertormed under this permit - c ec a apply: ❑HVAC Gas Tank Gas Piping Shutters ❑ Windows/Doors ❑ Electric 0 Plumbing Sprinklers ❑ Generator ❑ Roof Roof pitch Total cost Sq. Ft of Construction: S Ft. of First Floor: of Construction: $ AI 0007 16 Utilities:Sewer ❑Septic Building Height: Q7 C:> Q {r,rC8,x,� ''`a` 9• »;"�8'i�� '� r t '�si�k q f"ai;�i ..4"x k v"':: i; Name: Name Address: Company: I S / /21^ 4!�_-MEIL— 402 city Zib : �%' �/ 2 C � State: �~ Code: C ©Z2 Fax: Address: City: State: Phone i No. ~7'72- 'LOS-- �/Z E C W/ Zip Code: Fax: E Phone No. IMail: in fee simple Title Holder on next page ( if different Fill E-Mail: from m the Owner listed above) State or County License: If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. �a # *� r �E�x"� We DESIGNER/ENGINEER: — Not Applicable MORTGAGE C MPANY: — Not Applicable Name: Name: Address: i Address: City: State: City: State: Zip: hone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING CO PANY: _Not Applicable Name: Name: Address: Address: City: City:_ Zip: Phone: Zip: hone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. 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 whhich 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 Tender or an attorney before commencing work or recording our Notice of Commencement. of Owner/ Less e/ ontractor as Agent for Owner Signature of Contractor/License Holder Signature TATE OF FLOR DA j ?u Ue� STATE OF FLORIDA COUNTY OF ND I COUNTY OF he for oing instrument was acknowledg efore me 0C��f'_(/ The forgoing instrument was acknowledged before me day 20_ by this day of 2019by this of UPI l 1►�rm M . C� U� Name of person making statement Name of person making statement Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identific ion %�— Type of Identification Produced r ced , �41� mmft ex (Signature of Notary Public- SVtE (Signature of Notary Public- State of Florida ) PUBLIC Commission No. OF FLORIDA Commission No. (Seal) GW13898 s 10/28/2020 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE ` RECEIVED ) ©` DATE I COMPLETED CN" lei' is I Rev. 8/2/17