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Home My WebLink AboutBUILDING PERMIT APPLICATION- All APPLICABLE INFO MUST BE COG:._ °TED FOR APPLICATION TO BE ACCEPTEL- Date: k-� Permit Number: SCANNED �. BY RECEIVED air" j . W ,r �. . St. Lucie County DEC 10 2018 Building Permit Appliea Srlucie County, Permitting Planning and Development Services Building and'Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: Address: e.40-C /C� 3Zirisj Legal Description: 1,;me 6 - 1, -2. Property Tax ID #: ln3%�- Boa- d0� - oZ Lot No. /oiaa Site Plan Name: .(/Br�^�Vs»'�H� Block No. Project Name: Setbacks Front Back: Right Side: Left Side: •>- �- bias Tir%� %� liaro%e `a/n s/id/n-Y o vie l' lie,a /'D es.-isAlma �119'/1f/' OEM ttiona w r tobepertormecl under this permit -check all that apply: X, Jam'/H _Mechanical _ Gas Tank _ Gas Piping _ Shutters 'F &6indows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: .e/o Sq. Ft. of First Floor: vo Cost of Construction: $ zz&14�90. Utilities: _Sewer _Septic Building Height: Name OfC7,nq JelName: 4sn Z&lselA Address: &ire- Company:&ti /seAz_Zoos }. Z-saL City: fib. /oiePc. a State: Address: 4Z/10 4;,,vni' fir,ye Zip Code: 3Y797 Fax: City:1f_1 ;iz sovc -ts lamd State:. FL Phone NoJ%Z—q6q-8031 Zip Code:Yiti9 Fax: E-Mail: 1 Phone No 7%,Z- oZhd - 13OF F111 in fee simple Title Holder on next page (if different E-Mail Ar Ae, A a 7L% AA ' e from the Omer listed above) State or County License G �� If value of construction is 2500 or more, a RECORDED Notice of Commencement Is required. DESIGNER/ENGIN R: y1/I�ot Applicable Name: I MORTGAGE COMP Y: Not Applicable Name: A114 Address: Address: City: State: Zip: Phone: City: Zip: State: I Phone FEE SIMPLE Name: Address: TITLE OLDER: Not Applicable I i%4 BONDING CO,MPPAPJ : _ of Applicable Name: I Address: _ Zip. Phone: I 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 Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conIct 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 Iwith 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, accessorystructures, 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 commencin' work or recordingour Notice of Commencement. Signature of Owner/ Lessee Contractor as Agent for Owner Signature of Contractor/Licen. Holder STATE OF FLORIDA STATE OF FLORIDA r COUNTY CIF COUNTY OF The forgoin yinstru ent� as acknowledged e�ore me The fo in Yinstr ent� s acknowledge by re me day 20b this day of 20 b this of (Name of person acknowledging) edging (Name f person acknow edging ) (Signature of Notarybli - State of Florida) (Signature of Notary Public- State of Florida ) Personally Known OR Produced Identification Personally Known V/ OR Produced Identification Type of Identification Type of Identification Produced KAREN S. NIELSEN Produced COrllmlSSlOn NO. �O`�r •U��'O State of FIORQ�'NPta�Y Public 0 zo�gaa , Commission No. ::�•>J KAR ommissi My Commission Expires oastato of Florid, -Notary y • Com Notary Public mission 12 2022 P�; p Cr "m �"` �mi Jc lion Expires REVIEWS T ZONING SUPERVISOR PLANS VEGETATIO e t ROV COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.