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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMA YFOR APPLICATION TO BE ACCEPTED,- i �4 Date: Permit Number: -9 ova vP RECEIVE® Planni 9 Build, L >7 >72300 Building Permit Appl Commercial JAN 16 2019 Permitting Department St. LugE) County, FL PERMIT APPLICATION FOR: VV PROPOSi PJ INPROUEMENT LOCATION: I SCANNED. BY Legal • • n 1 .1 Property Tait ID #: 2 9 dk 6/ O l6 z coal Lot No. Site Plan Name: Block No. Project Name: � u Setbacks Front Back: Right Side:-:�r I Left Side: _Mechanical _ Gas Tank _ Gas Piping _ Shutters —Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch aFSq: Ft of�Construction: Sq. Ft. of First Floor: /�$6 A o.E:Construction: $ 79OC) Utilities: —Sewer _Septic Building Height: © NER/LESSEE:I CONTRACTOR: rNameh(rnic,f Name: Address: /2 2 0,.Jz Company: City: f=7 )04,c+ State: LC'1_ Zip Code: 3 y 9YS' Fax: 7%2 Y6 .. "9683 Phone No. 77Z •5 8Y G/26 Address: City:f State:_ Zip Code: Fax: % Phone No rE, Ma �jc �U9, . 4141r7., `o/,00 ,Gown 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. SUPPLEMENTAL GONSTR ON 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 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 f�ue Record a Notice of Commencement may result in your paying twice for improvements to yoeticommencement must be recorded and posted on the jobsite before the first ins i nd icing, consult with lender or an attorney before commencing w rdinR vour N ice Camr ncement. FN g Z LL� ti 1 ner/ Lessee/Con Factor as Agent forT RSignature of Contractor/License Holder NN STATE OF FLORID oX € STATE OF FLORIDA COUNTY'OF YW� OUNTYOF The for in g instru t was acknowledged before me this day 20M by 'r" he forgoing instrument was acknowledged before me _ is day 20_ by of _ of . v q w Name of persilin making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Iden is o Type of Identification Produced WI Jr..�Produced (Signature of tary Public- State of Florid (Signature of Notary Public- State of Florida ) Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS , VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVI REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Itt7II Rev.8/2/17