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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLFi. -;v FOR APPLICATION TO BE ACCEPTED _ I Date: Q /la A G �` *� Permit Number: •�i �5� a�� SCANNED '1 Lucie County Building Permit Application NOV 0 2 2016 Planning and Development Services PERPAI771fdG Building and Code Regulation Division St. Lucie County, FL 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: PROP©S'ED INPROUEMENT LOC*,4?T ON: Address: 3c7®S 60cicZ glocd Rorl a,-c-cyc FL , ZYgsl Legal Description: Ada? non, canci rcc-Acde ( Property Tax ID#: Site Plan Name: Project Name: .SQ(q (K) 0 i•-e 5 1d t Lot No. Block No. u Setbacks Front Back: Right Side: LeftSide: f DETAILED DEySCRI'PTf©N ® WORK: 4- t.et 11 Ine J P, _ itNA+ r%n riG rvie rnnA^ �• l.. .... ��• - llNitTiiiiTtrliT[�ii1�tlRiTTitilf�.7tTT.7!F11[it�. _T:Cliusu II."0 1 7r , . , _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors VElectric ✓lumbing _Sprinklers _Generator _✓Roof Total Sq. Ft of Construction: I q Sq. Ft. of First Floor: Ilia l 4131 ' t er Cost of Construction: $ '7�Q I (DO Utilities: Sewer Septic Building Height: y ®WNE /LESSEE: CONTRACTOR: Name mck} <_o c�at,M4cs' Name:" Address: 5 C'_cc+cr givc� Company; i 1 City: Fort_ e( crC c Zip Code: ,�Ll cl 16 1 Fax: Phone No. ('77a ) K7S state: FL 6672- -Aiidressr - •-- ---- _:_.-._ City: State:_ Zip Code: Fax: 1 Phone No E-Mail ot-nqr I 3 1 q rA d 77a Mq,'/.Coe Fill in fee simPIJ Title Hol r on next page (i different from the OWner li ed a ove) 2,lv^ q og p "1 E-Mail state or County License If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. 6AIRVIEML CONSTR ION LIEN LAW INF® MATIAN: DESIGNER/ENGINEER: Name: _ Not Applicable n" knr11 MORTGAGE COMPANY: _ Not Applicable Name: Address :21 2 S F1. sc Grr i e- Address: City: —P—er f s+ • L ruc C4 Zip: 2ca q C Phone '7 State: _ FL 73 46 ro S S o q City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: ✓Not Applicable BONDING COMPANY: _ of Applicable Name: 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 rnmmnnrino mrnrk nr rorni-dinv vnur Nntire of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 41 COUNTY OF The forgoing instrume t was acknowledged before me The forgoing instrument was acknowledged before me this a day of MIN, 20_VQ by this _ day of . 20_ by (Name of person ackno ledgi (Name of person acknowledging) U-11 (Signatuof Notary Public- State of Florida) (Signature of Notary Public- State of Florida ) / Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification Type of Identification f Identification Produced KAREN S. NIELS .,���,,:,o. tiro ced 637. Commission No.� 1 ' Commission q FF 1 1 a", eacNy commission Expir8nn --%,;n,,, 201 il ission No. (Seal) June 12, REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW EVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED I DATE COMPLETED ev.