Loading...
HomeMy WebLinkAboutBUILDING PERMIT APPLICATION- _ l All APPLICABLE INFO MUST BE CON-,- E rED FOR APPLICATION TO BE ACCEPTI j 1 Date: �o{. �• ) R • Permit Number: } RECEIVE® _ Building Permit A I cat' , i; pp ionDEC - 5 2018 Planning and Development Services Building and Code Regulation Division Permitting Department 2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie C II FL Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial PERMIT APPLICATION FOR:�D j 1 tee-E-er— PRQP ESO D INPRObEMENT LOC%A"110 Address: SCANNED Legal Description: BY St. Lucie C ianty Property Tax ID #: " 0 Q00 ^ Lot No.'!:�_ Site Plan Name: Block No. Project Name: 0-11 Setbacks Front Back: Right Side: Left Side: pETAILED DESCRIPTION OF WORK: CONSTRUCTION INFORMATION: MUU1LIUFJdJ worK to De performed under this permit— check a tat app yc _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Electric yl'lumbing _Sprinklers _Generator _Roof Pitch TotallSq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ Utilities: _Sewer _Septic Building Height: ERi/LES EE C©N`�TRACI.OR: Name Name: Address: Company: City; �[�� Stater Addres . Zip Code: S44 $ 7 Fax: City Sta Phone No._— c�i LLv Zip Cod Fax: E-Mail: Phone No Fill in fee simple Title Holder on next page ( if different E-Mail o from the Owner listed above) State or County LicenseLEG (") Q? If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. C SIMPLE TITLE HOLDER: State: Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: _Not Applicable Address: I Address: City: I 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 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 lender or an attorney before commencing work or recording our Notice of Commencement. Signature of Owner/ Lessee/Contractor as q ent or Owner I Signature of Contractor/License Ho er TE OF FLORIDA,/%/ ' STATE OF FLORID Qf NTY OF /i. COUNTY OF forgoing instrLZentwas acknowledged efore me R clayof eC.• 20LY6y The fo oing instrument was acknowledged before me s thisYdayof �8�• 20/Sby # m F /� laT 0' �l� V �1 m S O 'V QZ. Off. - e of person making statement. Name of person making statement. �3 ZE P,� r 3nallyKnown 1L OR Produced Identification Personally Known OR Produced Identification i3 of Identification Type of Identification uced Produced f (Signature of Not66 Public- State of Florida) t (Signature of NcMry Public- State of Florida) mmission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Hev.9/Zb/18