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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI 9 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: SCHNNE6ermitNumber: BY St Lucie County RECEIVED _ -- Building Permit Application MAY 12 1015 Planning and Development Services 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 r Address: % .�� Legal Description: Property Tax ID #: 2 0 2 `— o2 © a — Lot No. Site Plan Name: r yiC _i f.G je4&2-s� _ Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: CONSTRUCTION INFORMATION: Additional work to e e orme un ert ispermit—checka apply: 0HVAC 11GasTank E]GasPiping Shutters ❑Windows/Doors gelectric 0 Plumbing ❑Sprinklers I� _ Generator Roof Total Sq. Ft of Construction: S Ft. of First Floor: Cost of Construction: $ �6 SD. 0 a Utilities:Sewer Septic Building Height: � �o? if OWNER ESSEE: CONTRA R: Name ame: Addres • &0 Company: 1,4 City: Stated Zip Code:519 _4 Fax: Phone No. 77 2 /9 7 5�,}j Address: , City: ,9A1% PGP/J/ o, State:_' Zip Code:3 Fax: Phone No. 7 7-2 E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mailb A)S_ 40 State or County License: %B aflP) 1S'� it vame or conxrucaon is ac3uu or more, a xtwxucu Nonce of commencement is required. SUPPLEME TRUCTION LIEN LAW INFORMATION: DESIGN NGI EER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: S te: City: State: Phone:./ ­9 8 371— ?ail 3 Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: 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 andcovenantsthat 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. s Signature IContractor/License Holder _ Si Lure of Owner/ Lessee/Agent J STATE OF FLORIDA - COUNTY OF . �,� STATE OF FLORIDA � ,^. - COUNTY OF , The fofgoing Instrument was acknowledged before me this +L day of 20 j5-by \e� The for oing instrument was acknowledged before me this�day of roc �, 20 K by (j (Name person acknowledging) (Name ofZIrson acknowledging) p (Signature of Notary Public- State of Florida) (Signature of Notary ublic- State of Florida ) _Personal own OR Produced Identification o Identific d r rso Ily Kno OR Produced Identification Type o Identification Produced. VpTD Notary PU6fic37�eaf Florida Commission No. g " 'e L Lam Seal) My Commission EE 159174 Expins 01/25/2016 Commission No. +°� �c,,' ry Public Sml4E6lll�londa r " Trade L Lamb My Commission EE 159114 OFF Pines 16 Revised 07/15/2014 REVIEWS FRONT COUNTER ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEATURTLE REVIEW MANGROVE REVIEW DATE COMPLETE INITIALS