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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLLE� INFO MUST BE COMPLE ' '- FOR APPLICATION TO BE ACCEPTED Date: / /V Permit Number: U V I SCANNED •04 BY - - --- . Building Permit ApplicatioSt . Lucie County 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: L )i PROPOSED INPROUE-MENT LOCATION Address: Il/ qr/I lL i / 77977 Legal Description: PropertyTaxlD#: �`���— 5da- ddd3�da0-a Lot No. Site Plan Name: Block No. Project Name: : �i4 Setbacks Front Back: Right Side: Left Side: DAILED DESCRIPTION OF WORK: CONSTRUCTION INFORMATION: Additiona wor ,to a pe orme under this permit -c ec an tat apply: Mechanical _ Gas Tank _ Gas Piping _Shutters —Windows/Doors Electric _ Plumbing _ Sprinklers _ Generator _ Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ �Oyy — Utilities: —Sewer _Septic Building Height: ©WNER VESSEE: C©NTRACTOR: Name Address: 0'1 Okwejkle Name: Company: G ckrL City: / 61LP State: � Zip Code: .3 clo 2-Fax: Phone No.-7?2 -YOLL 0265 Address: 4)'W✓1 , 9 t0 City: y State:_ Zip Code: '�YC/-7-7 Fax:��c��' Phone No Ou/ 0e-2 >% E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail ,; /V �+ G�P��Y�C • �d �C State or County License O / lCV es G If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. 501PPLENIE TAL CO ON19CTION LLEN 1N INF11 OR ATION: DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: _Not Applicable Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/ CONTRACTOR AFFIDVII 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 cornmencing work or recording our Notice of Commencement. /O ' ticAhture of Owner L ee/Agent e of Contractor ense Holder SignrE'OF STATE OF FLORID % / COUNTY OF C�h L Lei Q STA FLORID r COUNTY OF__�� I? — The for oing instru ent was acknowledged b re me this � day of v 20_ by The forgoing instruyr9�nt was acknowledged before me this '/ day of 20,L> by <C/ (Name of person acknowledging) 1 (Name of person acknowled ng ) (Signature of Notary Public- St6te of Florida) (Signature of Notary Public- SIste of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Ide of do Type of Identifica ' Produced Produced14o Commission No. •••��°=DA4r�JI�ONE Commission MILpgE Lary Pubbc - Slere or Florida •- My Comm. Expires Mar 22, 2o17 ' - he . AlI Co State o! =:� - �p gym• Ezplres Florida • .; REVIEWS 8 RQNTz �,rSj n r Nalion I I OR PLANS "" If .. ih VEG AIlfW3FyAss o on NEE 877571 ` ANGROVE COUNTER REVIEW R E REVIEW REVIEW E • REVIEW DATE RECEIVED DATE COMPLETED Rev. _ , n FOP_'a_4 n