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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: SCANNED BY St. Lucie County�b - _ MMRBuilding Permit Application OCT 42015 Planning and Development Services PERMIT' ;;, St. Lucie 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: ROOMM1 Address: Jn7(Ag 1� nr'-paai Llr/.v Legal Description: Property TaxIDA: `S - Lot No. /�� Site Plan Name: � L )^ ( 'uIr a Block No. - Project Name: / s � yu ill Setbacks Front Back: Right Side: Left Side: ,}irlt %+,'e (b •�zC ay'..x �Xs x rrnicw ",. {-T tS1 Y rr*Go- i a`SFeP.S'a`4 t#S s - �'gs t �" v, '$.`i.+ +t3°' "�`t' Y U i�x}.t G/n! UPs fu Gf ��N� %^n 7s� 1Yi s�Q_v�a ] �lq� �GONj��fiI3U�C��QFY�������A"tlO% •l'�i�`"i�F`c`v331�sf.6w(�#ilcypya nTX ��33}��ff iaV??fi3 fiG fi.xa�[ 1tlona wor to epe ,orme under tis permit - cheCK all tnatappy: _Mechanical j-asTank tasPiping _Shutters —Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: Costof Construction: $ / NU. Gu Utilities: _Sewer- _Septic. _ _ _euilding-Height: f` m;',k: "yX. 'S�•''E B+ INNONjar TN}V.�Ntt`R� �#'- 3©Ri iY++.'is Ut'-x�.,3}yk`�. ''1i-; ,$4r 3�' �1L�Tjc��r?L'� Se Lail' M ��✓da-� { /��+ Name 65 Tc, MEQV I/ l Name: `9nry FrCgc Tn, Address: C1 Company:29rnnr r City: �/� �y. i� State: ,LJ Address: 33 o/ City: /ilrr-e Stater Zip Code: '37S'i� 1 Fax: Phone No.� '7'L tI/G :2 FG Zip Code: 319 joo? Fax: 2 7 L - rW r- E-Mail:,rl,,I, Z0.2 ad;"nnrfas./cn PhoneNo.-?V -633 -0750 Fill in fee simple Title Holder on next page ( if different E-Mail: i o State or County License: S�7 from the Owner listed above) If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. -Y ralfhPl;A��LNi(�, tN.T Sibs!/{.r.��C J�T��.YifjFr:e i�IM ii.* DESIGNER/ENGINEER: Name: lJl ©#(U�INRORJiAi(� llYl�j1.{\?'N�tynh.).. f e iai4M. _ Not.Applicable i!1fitf'.yd Li F.F. _ NMI' MORTGAGE COMPANY: Name: Address: _ Not Applicable Address: City: Zip: Phone: State: City: Zip: Phone: State: FEE SIMPLE TITLEHOLDER: _ Not Applicable Name: BONDING COMPANY: Name: Address: _Not Applicable 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 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 TO OWNER: Your failure to Record a Notice of Commencement may result In your paying twice for ants to your property. A Notice of Commencement must be recorded and posted on the jobsite first- nspection. if you intend to obtain finanpWtg—,cbqsult0^Iender or an attorney before STATE OF*WRIDA COUNTY OF S T Lde i-, The far oing instrument was acknowledged before me thisdayof r 20/'by ®cam (Sign Lure of Notary °Personaliy Known 1 Type of Identification Commission No. REVIEWS I FRONT I ZONING COUNTER REVIEW FXPIRES Jury ST Lac t w The fgrgoing Instrument was acknowledgbefore me this day of U26 S REVIEW R REVIEW I V REVIEW" S REVIEW EWLE I MR VIEWVE