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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COW�WLETED FOR APPLICATION TO BE ACCEPT'" ' IQ ' Q 3a Date: �. 3 I00 m Permit Number: �jl RECEIVED Building -Permit Application. Planning and Development Services MAR 13 2019 Building and Code Regulation Division LsLucie Coun , Permitting 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: .. Address: -) `I `u JQtAVecA V\YN -S U1 . /"011-- J-Ie'ac y 7d- Legal Description: St. Lucie Count Property Tax ID #: Site Plan Name: Project Name: _ Setbacks Front Back: Right Side: Left Side: Lot No. 0 . M o'oJf q-ty1F Ukt(ILL-ft, .3' W1 -30'tong. �"' 4164 Poor /o'x /q' slc. 6 oerf �I-rsr,, SA&J eyo rv4re _Mechanical _ Electric _ Gas Tank _ Plumbing Total Sq. Ft of Construction: Cost of Construction: $ S 0000 _ Gas Piping _ Sprinklers _ Shutters Generator Sq. Ft. of First Floor: r -Windows/Doors Roof Pitch Utilities: _Sewer _Septic Building Height: 0 WNER/LESSEE; CONTRACTOR: Name A)l Coe Lrn 1& Name: Address: 3ygSSa//ten met Dr. Company: City: ro/1- Oo—e FL State: G Zip Code: 3 `f f=8''J. Fax: Phone No. 77 9--le(J-S7,r/S' . Address: City: State:_ Zip Code: Fax: Phone No E-Mail: �D%00)A 004 e eew? . '14hpe, 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. UP LEME AL G©NSTRU IT L EN LAW INFDRMA�TI * N. 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 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 commencine work or recordine vour Notice of Commencement. Amy dJ'k(Z' Sign Are of Owner/ Lesse ontractor as hent for Owner Signature of Contractor/License Holder STATE OF FLORI STATE OF FLORIDA _ COUNTY OF_� Val it, IF, COUNTY OF The for oing instrument wa acknowledge before me � The forgoing instrument was acknowledged before me this day of �n � 20� by this _ day of 20_ by Name of person making statement. Name of person making statement. / Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification Type of Identiffat. Type of Identification Produced N"C 'l)L _ c T�� Produced (Signature of Notary Public- S _ .. ature of Notary Public- State of Florida ) KAREN S. NIELS N ,x tat of Florida -Notary Notary Commission No. '• a4mission # GG 207 u mission No. (Seal) :7 My commission n Expir s June 12 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW CEIVED [DATE TE MPLETED ev.