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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLEINFOMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 'i(1p, 72 Date: -L4- Permit Number: IYE/Sf �Is�� SCANNED BY St. Lucie County RECEIVED Building Permit Application aPR 0 A nms Planning and Development Services Pe Mtttw� unty nt Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34992 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential y/ PERMIT APPLICATION FOR: FR©'POSED tINIPROVEMENT LOCATIOi : « ,® n Address: _ 30 3 'RV C Lt.� -1 , Kai p1C.-e CFctC/ % Legal Description: Im.,.d N Ai a'o 4 a r- 1_0 1- off, Property Tax ID #: Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: CONSTRUCTION INFORMATION U ; ,A. _Mechanical _ Gas Tank _ Gas Piping Electric _ Plumbing _ Sprinklers _Shutters —Windows/Doors nn _ Generator rRoof Pitch Total Sq. Ft of Construction; d Sq -Fti bf First �loor.:,t,' J y!a , n v Cost ofCgsxruction �.'L � •off Lltllit(es*. 4 ew�rl'�ipeptic`' �wldingHeight: OWNER%AE�SEt's :i. sCONTRAGTOR Namev % ✓l Name: �J O Address:_��n� I-)JP�I P Company: I)A (pS P�- -J con City: �l� F�l 21CC� State: _12L Zip Code: '4-�(- 94 _) Fax: Phone No. Address: &- OG e L AL) e__ City: �C)A- I i 2.CC_e Stater Zip Code: 3u Ct L-(Fax: Phone No S - 4q E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-MailQA0& 0' State or County License CCC I If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: . _ Not Applicable BONDING COMPANY: _Not Applicable Address: Address: City: City:_ Zip: Phone: I 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 antl 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 commencinDwork or recording your Notice of Commencement. z Sig Iure of Owner/ Lessee/Contract r as Agent for Owner Signature o on ractor/License Hol�r STATE OF FLO DA STATE FLO IDA COUNTY OF __ n �c �G�— COU OF0. r Lc The forgoing instrum nt ways acknowledged before me this 1 ay of r� I 201j^ by The forgoing instru ent was acknowledged before me this, r" 1 20-0 by ay of L O-44 LIok4d con,5;kg+- (Name df person acknowledging) (Name of person acknowledging) Ipp (Signet a of Notary PubW-104 (Signature of Notary Personally Known�6B�i6Bta�Rt 9� Z022 Personally Known R.:P& �� ( (011Type of IdentificationBpj�gd TigU A81011 r Type of Identificatio ��_ � dP �� � Produced Produced Bonded UM Arlon Notry Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW [DATEEECEATE OM Rev. 7/2014