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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTE9' _Date:_ 1' �� _ _ -- n��-P_ermit-Number -� - —�-�-- NO RECEIVED 6 tl JAN 0 9 2019 --- �— Building Permit Applicatio T. Lucie 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 �r • y �`® PERMIT APPLICATION FOR: /2A Address: 1233 1 I Description: PF--S 4r ipmF S u 1 oT Vropert-&X #. ` L''I M , 70 S1L-Y A1-G LOT a Zgj, Sf Pr /?' evfs tf. LaPc.)(o4 3 Site Plan Name: Project Name: 6%1(IA CY /21=SIOF--NGE Block No. Setbacks Front aS-, Back: ��� Right Side: /0 Left Side: /0 r a0r ;$ipE Logwep- BUlL6 A&W l*/1 C /0 lA% t,L49& SEPTI(- c,r1 uJrfLL SEE /P4sw6- J - a- /Ia C.,g7 ` 07 s �*•y -2�Mechanical _.Gas Tank _GasPiping _Shutters )LElectric X Plumbing _Sprinklers _Generator Total Sq. Ft of Construction: O Sq. Ft. of First Floor: _ Cost of Construction: $ $ 10.04 019 Utilities: _Sewer _Septic 7 Windows/Doors Roof 5 /2 Pitch Building Height: OWNER/LET-S'SEE� GONTRACiOR: Name Rod MAZNOT RuiL.ME r' Address: abdN ROS7vV C� Company:' City: State:_ ' Zip Code: 33 V6Z- Fax: Phone No. S� f-637 Y Z -Address: I« City>.. +' State:_ Zip Code: Fax: Phone No E-Mail: 9096A2NCz11CdJ'JST(1yCr1a..✓ 614191L.Cc Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail State or County License GQ L / Z ��rl �9 If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTI • N LIEN LAW INFORMATION: 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: - 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 thepermitholder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or an 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 Lessee/Contractor as Agent for Owner STATE OF FLORIDA n Q 11 COUNTY OF lr rJfALi� Signature of Contractor/License Holder STATE OF. FLORIDA COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this L/ day of ©c"62/ 20 Vv by this _ day of 20_ by A®/>, c% a (Name of person ackno edgi ) ('a,d, A -4,,JL- (Signature of Notary P bli State of Florida ) Personally Known OR Produced Identification Type of Identification_ (Name of person acknowledging) (Signature of Notary Public - State of Florida') Personally Known OR Produced Identification Type of Identification Commission No.GG f04aS2 ii CANUICtA.munbnnn nnm ission No. (Seal) Commission# GG REVIEWS I FRONT REVIEW I REVIEW PL110 PLANS I VEGETATION SEATURTLE MANGROVE REVIEW REVIEW REVIEW REVIEW