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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: RECEIVE - Building PeMftApplication _MAR_18 2019._ Planning and Development Services BY sT. Lucie County, Permitting Building and Code Regulation Division St. Lucie County 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential ✓ PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III Address: Legal Description: Si "'e taaae s 23 36 'to BuC 3 S ►'2 OF i ar I - ZZ55 Rb 0e 10 -(4do2 AG) (MAp 34/z35) Property Tax ID #:.3t'114- 50I ^ 07o I- 150 -S Lot No. / Site Plan Name: Block No. Project Name: S J50-n SC-KA10nan Setbacks Front Back: Right Side: Left Side: 4r,. rr6.. rs. st✓S ..� a. .,v �:..d.l_. ...a,,, v , _.5�-.. r a. Sc-34- ae f_LEG`r_i G/PV ❑ Windows/Doors Roof Total Sq. Ft of Construction: S Ft. of First Floor: o� Cost of Construction: $ 900. ap Utilities: Sewer Building Height: NEf�IiLESSE 'r. 'i GONT9:%_§1TOR. ',� Name Susan 5a4-W' lrr.nn Name: RnoD J, Zro\lttclL Address:%415 Silver DaY-'PC Company: So\G1 En2rgaSMS-Viecn.-S City: q-% 54- L LCi . State: AEG Zip Code: 3Lg5'.Q- Fax: Phone No.51(y-j15(v-r-(6DI Address: 1100 Smallwood A r� City: Fk 9;erct Zip Code: 9LIgS.O Fax: -112--46In--1g3i Phone No. '712- 4"L1-261e3 State: FL E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail: Srr�90 ar e� State or County License: C oStet„�S"1 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. (N.uY.tn �U� L�� E(�TAL C©NSTR C�+TION LIEN LAB: INFORMATIQNIY• � DESIGNER/ENGINEER: Name: _ Not Applicable MORTGAGE COMPANY: Name: _ Not Applicable Address: Address: City: Zip: Phone State: City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: Name: _ Not Applicable BONDING COMPANY: Name: _Not Applicable 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 commencing work or recording your Notice of Commencement. A "y &4A4'L Signature Owner/ Lesse tractor Agent for Owner Signature Contractor .se Holder of as of STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 54. It .u2 COUNTY OF SIr U GiG The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me thi day of Mdf6:'1 , 20 n by thisl day of Cr\oweb. , 20A by /s' R(A�gr - ZQ`i) &C-L Name of perso9 making statement Name of person making statement � Personally Known ✓ OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary Public - State oridM)�eSarah Musk (signature of Notary Public- State ofbrdMaiusica NO ARY PUBLIC Commission No. 1217E OF FLORIDA t NOTARY PUBLIC Commission No. �9l2137 0ATE OF FLORIDA Corn# FF912137 gCE 19�0 E Ires 8/24/2019 Cornrtdt FF912137 �tsE Ires 8/24/201 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17