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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COIL"..-,_=TED FOKAPPLICATION TO BE ACCEPTEL - I )I� Date: � � • �• � Permit Number: `Tc I r� l�L RECEIVED J Building Permit Applicatio NOV 0 5 2018 Planning and iDevelopmentServicesGazy\cr ST. L-dGi� County, Permitting Building -and Code Regulation Division. - -- 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commei'Cial Residential tv PERMITA�PPLICATION FOR:*S4 Address: W/O r 1. Legal Description:_ Property Tax I #: Site Plan Name: N,9-5y0'©217-000- SCANNED —CMr 3 Project Namei: vAc v, Kes idP-ht¢ -A e-d ro, Oetbacks FrontN)4 � Back: Jr Right Side: Left Side:mill Lot No. Block No: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors ,Electric _ Plumbing Spr-;klers _ Generator _ Roof Pitch Total Sq. Ft of Construction: -71 'I M t�� Sq. Ft. of First Floor: Cost of Construction: $ �®P)P �` . ,.Utilities: —Sewer —Septic Name Address: 11W' 0S city: pa�� S� L✓�� e State: L Zip Code:3 Fax: Phone No. IM 7 1,17 -e 173 E-Mail:' t�`P37-`i16®aml.cc, Fill in fee simple Title Holder on next page (if different from the Owner listed above) Name: Company: Building Height: W35" Address: City: State: Zip Code: Fax: Phone No E-Mail State or County License If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. Name Addre City:! Ziwla FEE SII Name: Addre: City:_ Zip: _ Not State: Phone TITLE HOLDER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Address: City: —State:. Zip: Phone: BONDING COMPANY: _Not Applicable Name: Address: City: ne• Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to dot . hework 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 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 accessoryuses 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. 7gr atur.gf f�iTWne'r/ Tessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 1 COUNTY OF The foEgoing instrume t was acknowledgebefore me The forgoing instrument was acknowledged before me this -�— day of I\��9 V . 20by c Aw t I KN0,AIJ this day of . 20_ by (Name of person acknow edging) (Name of person acknowledging) (Signature 6f Notary Public- State of Florida) / (Signature of Notary Public -State of Florida) Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification Type of Identificapan Type of identification Produced L Produced I. `�1PpY PV��i KAREN-S. NIELS Commissio No. r:° �<;�(S084 of Florida -Notary �I)11.. ubR fission No. (Seal) _' •= Commission # GG 207 %; a' 84 %,?�oFF��;;• My Commission Expi es REVIEWS FRONT ZONING SUPERVIO NS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW . REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.