Loading...
HomeMy WebLinkAboutBUILDING PERMIT APPLICATION� � t ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED to Date: 1A N \1 1 ! Permit Number: SCANNED RECEIVED BY St. Lucie County Building Permit Application APR 17 2319 Planning and Development Services ST. Lucie C_o_unty, perm(ttinrZ 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: To Select from dropbox, click arrow at the end of line III I,fKUPUStO'IMPKUUEMENI LOCATION: I I I III Legal Description: Property Tax ID#: `�l%o?—&nto—ba10-Ono-9 Lot No. 1r)_9 Site Plan Name: Block No, A (O Project Name: Setbacks Front 19 , Back: Right Side: Y r Left Side: �_L7 /r DETAILED DESCRIPTION OF WORK: �` 11 roOA)aaf-L e.J OF 61J A-,& 30X-'fl) iCONTRUwCorON;INFOMATIM:- dfeIona to e e orme un ert is permit— JHVAC 0 Gas Tank []Gas Piping []Electric 0f5mbing ❑Sprinklers ti'(51A b Li rr`4b11 20 T �-T S a apply: _ Shutters F-] Windows/Doors ❑ Generator ❑ Roof ❑ Roof pitch Total Sq. Ft of Constr�uc0o n: ®ll ow d ScqiI Ft. of First Floor: _ Cost of Construction:`$' �a3C'�a _a a Utilities: l❑ Sewer ❑Septic Building Height: OWNER%LESSEE: -- ° . 'CONTRACTOR: Name AWLI 4 ert 4—o fr Name: f S & CD sss�:� 191 Silver © k Addrer� Nr Company:t=WHUS I^-,fip(7arn :AfC, T City: t terse, Zip Code: 34q 8cR Fax: Phone No. IQ — a I -a51 R State:I'L Address: 3(el 15- F:e2 City: . State:, Zip Code: 3 q q n q Fax: Phone No. 772.-2hl-9'397 E-Mail: Viol kIC'i rii0Ama ,bom Fill in fee simpler on next page (if different from the Owner listed above) E-Mail: Gig A H a in 77Z 019 �7� AI;5 % State or County License: r �1 aQ // & If value of construction is $2500 or more, a RECORDED Notice of Commencement Is required. i SUPP! tiE(VIENAI CONSTUGTi„�Ef�k'i AiN INFORNIAICS{�l .gS STa.'...hv..: o- ' " DESIGN/ENGINEER: _ NotXpplicable MORTGAGE COMPANY: _ Not Applicable N me: Name: Ad s: Address: City: State: City: State: Zip: N PIr Zip: Phone: FEE SIMPLE TITL O E • _ Not Applicable BONDING COMPANY: Applicable Name: Name: _Not Address: Address: City: City: Zip: Phone: ip: 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 IMPROVEMEN S TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Sig lure of Owner Lessee/C`ontrector2as`Agent pri9`wneru Sign ure df C6*&�aetor/License Holder S TE OF FLORIDA ST TE OF FLORIDAC C UNTY OF c� ,-1 �, COUNTY OF �i The forgoing instrument was acknowledged before me this day of o, ' D 201 by The for oing instru nt was acknowled ed before me this 7 day of 20� by —�r UILAS C747X\e\a✓Y\ Name of person 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 Sri f D ` (Signature of Nota ublic- State of Florida � FRANCES V. JOf. (Signature of Notary Pub[' - tate of Florida)1 S h'S�;`..°. a4 4 ,.� o MYCOMMISSIONOC Commission No. G6 3�+ �$i3�11+ vxv'ea 03QQ30 �'�•••"•�n FRANCES V. JO mI5510n No. fnm G7 �� + _1,611 MYCOMMISSIONgG � �k Y EXFigES:O•..nb=r i'�"e#LLa� suaMr.�':�c r� sFiu, q�oF�oA�°< saEXPIRES:Oruber2g REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.