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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INNCFO MUST BE CCI vir'i.ETED FOR APPLICATION TO BE ACCEPTE't, l Date: �7 . 2%- 12 Permit Number: 1 �Q UO RECEIVED Building Permit Applicati n DEC 2 8 2018 Planning and Development Services Building and Code Regulation Division ST. Lucie County, Permitting 2300 Virginia Avenue, Fort Pierce FL 34982 }' Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential ./ PERMIT APPLICATION FOR: Address: W' Legal Description Property Tax ID #: Site Plan Name: _ Project Name: Setbacks Front 411?ON as K-w bt Ipa f M6)& 3,5 L1 Back: 2_ Right Side: Left 0 Lot No. Block No. L7s- ll i �S iK p, 6to"3e— ity-L 1, Or ©21 L '& L E L Lk j QiiL-Pl i _Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors Electric _ Plumbing ' _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: "G `i Sq. Ft. of. 1.First Floor: 14 q Cost of Construction: $ i�A . 13 Utilities: —Sewer _Septic. Building Height: URER'HESS -E: CONTRACTOR: Name Cc Name:' 4 -,S Address: dco 1 ecc�o Company: City: V o f p'0,'�Cl/ State: A— Zip Code: 3 , 1 Fax: Phone No. '71 3i "90l -'7 7%5�1 Address: $ul�-6- G D 1 D AJ 4 City: 0 r OAQ State: VL Zip Code: 1141-1 Fax: Phone No Ltu .�-9�`� � I E-Mail: VA45te.&�b� RV& 8 M4l 1 , r-C M Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail State or County License If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: _Not Applicable Name: Address: 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 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 As 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 vour Notice of Commencement. 'Signatur6 of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA i STATE OF FLORIDA COUNTY OF i 1t . COUNTY OF The for ing ins ument was acknowledg before me The forgoing instrumen as acknowledged before me this day of t C' 20� by _C-lsq 4 , A0 this _ day of 20_ by Name of person maki g stament. Name of pers making statement. Personally Known OR Produced Identification � Personal Known OR Produced Identification Type of [dent ifica 'on Type of Identification Produced L es� Produced (Signature of Notary Public- nature of Notary Public- State of Florida ) Commission No. KAREN S. NIELSE ;_° 4� �r]� ia�jIyQ! Florida -Notary Pu •_ `GI7RIR1iS5i0n n GG 2074 lic mission No. (Seal) My Corn mission Expir s �Onnn `P` June 12, 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW AEVIEW REVIEW REVIEW REVIEW DATE RECEIVED I� DATE COMPLETED rcev. a///ly G