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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLEftu FOR APPLICATION TO BE ACCEPTED Date: aA1 Al �G Permit Number: `GO 'Q,-d aa4 • RECEI'.'-D Fr3 112016 SCANNED BuildingPermit Application 13Y __ pp St. LucieCounty 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 X Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION; 4ddress: I OLL6lei 11UC=" SGwo) Legal Property Tax ID #: Lot No. Site Plan Name: lli 1 /L , l ll i m l I'IN L Block No. Project Name: I'7= i'{'yYlYjlLoit_.I Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF=WORK. PCla' CO-y-(^gjc 510-b - Hit Rb2r 1l2 CONSTRUCTION INFORMATION: ' itiona wor to e e orme un ert -checkispermlt a apply: DHVAC 0GasTank E]GasPiping _Shutters ❑Windows/Doors Electric 0 Plumbing []Sprinklers Generator Roof Total Sq. Ft of Construction: 11�� "S20 S Ft. of First Floor: Cost of Construction: $ Ca'I�- Utilities: Ft Septic Building Height: OWNERAESSEE: -' ,CONTRACTORt Name 0(I YYI . i2b_:_M JInL Name:73 1 rne_n_i# Address`© =L- 1 Company: 7MN Rini IC�4V5 City: M=4 Stater Zip Code. Fax: Phone No. Addresnns:V,n!3k `a') el -of` cm a. City: Ll_ a c Statel:F Zip Code: EYM Fax:_7�%c3l(L�-�i► 01 Phone No. E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail: — ULA State or County License: It value of construction is 52500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTIO N LAW INFORMATION., DESIGNER/ENGINEER: Not Applicable Name: MORTGAGE COMPANY: Not Applicable Name: Address: Address: City: State: Zip: Phone: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ of Applicable Name: BONDING COMPANY: ./Not Applicable 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 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 commencing work or recording vour Notice of Commencement- " Signature of Owner/ re STATE OF FLORID STATE OF FLOPIgAW O COUNTY OF S lC COUNTY OF 1�L�1 The f oing inst was acknowledg d before me The f going instrument was acknowledged before me thiIss %� ddaay�of - 2t1�by this � dayof 20 � by a�1 (Name of person acknowledging) (Name of person acknowledging), Personally Known ),�' Type of Identification Commission No. Revised 07/15/2014 OR Produced Identification I Personally Known V iced MY.... a� �. Melissa McU Type of Identification OF FLORIDA I Commission No. FF030187 OR Produced Identification NOTARY PUBLIC f$$9 OF FLORIDA Comm# FF030187 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE r� ZI ZrI j COMPLETE V INITIALS /L( 2