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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE %;V'MPLETED FOR APPLICATION TO BE ACCrr i ED Date: i Permit Number: RECEIVED Building Permit Application NOV 05 M8 Planning and Development Services permitting Department Building and Code Regulation Division St. Lucie County 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: Address: Legal Description Property Tax ID #: Site Plan Name: Project Name: Setbacks Front ,�4'/ h. - r ii , /✓ /,, �, , --,, -- SCANNED 3o-7oZ--ooIa- ooc-/8 w A" I t o Back: t'.�r,'-'-,,r_Right Side: 2-6 f•�TLeft Side: %�1-ST —Mechanical _ Gas Tank Electric _ Plumbing Total Sq. Ft of Construction: Cost of Construction: $ Lot No. Block No. Gas Piping _ Shutters _ Windows/Doors Sprinklers _ Generator _ Roof Pitch Sq. Ft. of First Floor: �� G Utilities: —Sewer —Septic Building Height: OUIi'NER�LE��'S�5 E: CONTRACTOR: Name r,�S{ o h� Name Addres :.` �.s.3.-.,� /Gr..,,a ��` CoPany. 1� _ - City: /J �` `-e ` State:- Zip Code: 33 "Z ? Fax: J / Phone No. ��- J? 3 g " �i`/ 9 `r ' Address: ©;?--r- r_ c M v r s v� City: m .1`'e P"-� State:_e�� Zip Code: 2% f Fax: Phone No -92 E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) //��2 E-Mail Aa y 5� GC 17 el �j'� �' State or County License If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. S�UPPL-�IUIEN �,1. CO STR�l1CT1t� � LI��N 1111 IN�F � R+1�`/IA l�?i�: DESIGNER/ENGINEER: — Not Applicable . MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: State: City: State: Zip: Phone Zip: Phone: ail -FEE aSIMPLE ,TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable 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 all respects, perform the works 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. , Ae_z Signature - n r essee/Contractor as Agent for Owner Si na e o a /License Holder STATE OF FLORYDA ICJ STATE F FLO DA COUNTY OF a'e COUNTY OF f CJPt� The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged beforei me this may of tO 201b by. this Zb day of 20 by (Na of person acknowledging) (Name of person acknowledge g) 'do "J (Signature o otary Public- State of Florida) (Signs re f Notary Public- State of Florida ) Personally Known , • P� •.ro u LAYA Personally Known t �` Type Identification ° Type of Identification ?�'• f : Notary Public - State of Florida of ° Notary Public - S7eFldaProduced s`.= Commission kGG 208712 Produced a` Commission s y omm. Expires Apr 18, 2022My Comm. Expir022Bonded throw at' nal Notary Assn. Commission No. Bonded through ossn. Commission No. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW. REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ` ev. 7/2014