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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr- ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Co- y c- Permit Number: SGANNED BY RECEIVED ' St.LucieCounty, Building Permit Application JUN 0 4 2019 Planning and Development Services Permitting Department 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 ,PrROPQSED IKfiffi YOM"'E jTL' CAIII_ON: Address: �38 bimvni lid tric��n�on Zg14r,d, 344ctq Legal Description: (-'oroj qP H Seriion Otte.- 6L.K 3 L)-T-5 Property Tax ID #: jHZ6-701- 00%5'- 000-7 Lot No. S Site Plan Name: Block No.3 f Project Name: iilfi5Ja�hglAlnrkm rrn Setbacks Front Back: Right Side: Left Side: �D ILED b�SGRIPTION�'OWOR •: ¢ -.4. �� rt~M��� ;CONSTRUCPI®NFNQA .±: "i PiW:i'n.Yd�d.osa_w. ^pys' �f` i S +5".'`S•�#'•"k�.'` ❑°'� Additionalwor to tiertormed t ispermit-checka _apply. OHVAC Gas Tank �GasPiping Shutters /'Doo•.'rAs Electric 2Plumbing Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: S Ft. of First Floor: Cost of Construction: $ 3, `1t7i i . 9 Utilities:Sewer Septic Building Height: 'OV1/I'VER�/LESSEE: CONTiRgCTOR: Name Orxri- A'op)ng.ykc- \rnan Name: bar+ Zt-l ai.ClZ Address: 2.39 (3imins DC Company: $0k0.f 6r g!23M 15 54CM5 City: VkLLArch%n90n State: FL Address: 160 Src.wllu x: Q.e_ City: � 9iercz- State:�l. Zip Code:3t-19L•la Fax: Phone No.1-1� 539- IG10 Zip Code: 349 oaL Fax:-M2'cEidfo-1951 E-Mail: Phone No. -I l2- 4(o44- Zlpfo3 Fill in fee simple Title Holder on next page (if different E-Mail: So oo. co State or County License: from the Owner listed above) If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMEr�1<OIUSTR C*TION L•IE ` LAW�INF©RMA�TION': �F � ��"h DESIGNER/ENGINEER: Not Applicable Name: MORTGAGE COMPANY: Name: Not Applicable Address: Address: City: State: Zip: Phone City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: Not Applicable Name: 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 commencingwork or recordingour Notice of Commencement. rA)LJ'-- X 24a�Z,41L, Rev.8/2/1Z D t? K i' `U {^wl Signature of Owner/ Less Contractor as Agent for Owner Signature of Contractor/Li se Holder STATE OF FLORI A STATE OF FLORIDA COUNTY OF S j,urae— COUNTY OF S+ W_u2. The forgoing instrument was acknowledged before me `L�( The forgoing instrument was acknowledged before me this day of Ma.., 20� by T this�dayof,YYiCcT.0 20H by Zr-a1\aclL abet'-}' ZrcL\kacX_ Name of pers n making statement Personally Known � OR Produced Identification Name of perso making statement Personally Known � OR Produced Identification Type of Identification Type of Identification Produced 7vmccQ /Jar.e,4 Produced ll.e.4..e, rstL .a (Sfgnature of Notary Publ -State ofs rida Made Sarah Music (Signature of Notary Public- ate of Florida Made Sarah Music � Commission No. 12137 ( NOTARY PUBLIC STATE OF FLORID Commission No.FFPi1213"1 0 TARY PUBLIC �Q � ATE OF FLORID =�i Comm# FF912137 Comm# FF912137 s/9'CE l9'� J>ry 1a REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE ` _ COMPLETED b 2(