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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE CONi`IPLETED FOR APPLICATION TO BE ACCEPTL't, �l,�p9 St. Lucie County ` RECEIVED Building Permit Applicafi n FEB 04-ZO19 - Planning and Development Services ..ST.'Lucie County, Permitting 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: qV 7 Legal Description: /573- guy PropertyTaxlD#: 4-7,J b- 3[ Site Plan Name: Project Name: Setbacks, Front Z 5 Back: //I dC e, —0oo Right Side: _ Lo r Left Side: _Mechanical _Gas Tank _Gas Piping _Shutters Electric _Plumbing _Sprinklers _Generator Total Sq. Ft of Construction: /'Y`J fQ. CT Sq. Ft. of First Floor: Cost of Construction: $ 61Z1 V f 0- Utilities:, _ Sewer ..— Septic IV 17, f-,/ Lot No. Block No. '%,W i ndows/Doors Roof Pitch Building Height: OWNER Lf_SSEE: G© 'Mz cI& Name ( fLL, ..IJtir fC , . ':VLeu Pr2�r?� Name: C ci � L7r! l R /F V �+.1/. :;" i, Address-W74 Sa�rc kNatia Idiom �ti Companyt "vyT" C.'Nfrti Tu- C,rJfJ^ City: lt+'M1r r3w.:cct State:F1 Zip Code:?'l 4 Jr L Fax:' Phone No, e t 3 — 78 9 - 6Y77 Address:906 N✓ _S�s)gF��2. ?Ln' n.[i�� City: 'SZ�-� C" c`'`C4 State: - Zip Code: 3V f S 7 Fax: Phone No 860-GIq- 5Y9/ E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail ob State or County License 4 e - (Z6 06 3 V If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. MR., lE ENTAL GON U IONLIEN W INfi + R im ON: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name: BC 4AVI T6LT5 _ Name: Address: yua sd Creeo t¢ 5 t Address: City: SirvAtir- State: Ft City: State: Zip: 3%E99y ' Phone 77Z 2d 7 73 r y Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Name: 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 is in which conflict with any applicable Home Owners Association rules,.bylaws or and covenants thavmay 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 1 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'adcessory 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 record/el—and posted on the jobsite before the firsVtMpection. If you intend to obtain financing, co It ' I nder � r an attorney before commen ' or or recordingour Notice of Commenceme Signa r f wner/ Lessee/Contractor as Agent for Owner. Signature of Contractor/License Holder STATE OF FLORIDA� COUNTY OF LUc,�� STATE OF FLORIDA COUNTY OF The fo going instruperrit vyas acknowledged before me this day of 20 jq by The fo going instrument was acknowledge before me this 1 day of �. 20� by Name of person making statement. Name ofName of person making Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identificati Produced Produced % (Signatureoo (Signature of Notary KAREN . N or &.,, IELSEN `d,-,Stale 1n.o��n KAREN S. NIELSEN , Commission N ?�° _Stato.ot Ftoiida-ugly Pufilic of•FI' Ada- oiAryP.ubtic Commission No. '� p[� jj41 ' �i1GG 2W484207484 • •My'Commissien - - mission N, GG, 207484• missfonCpmmja ;y ExpiresCommission - -E%pires 12, 2022. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE' MANGROVE COUNTER REVIEW -. •REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED ' DATE COMPLETED' _