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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MusT BE COMPLu cJ FOR APPLICATION TO BE ACCEPTED Date: SCANNED Permit Number: BY E e St. Lucie County'�'��" Building Permit Application MAY 17 2016 Planning and Development Services PER!0rr-rivG 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: To Select from dropbox, click arrow at the end of line "'PROPQSED-IMPRObENIENT,�LOCATION..�� =� , °� � .� ;' . • • -. `; Address: S .O GGo? / 'T •o-�«C- Legal Description: e&eZ7ed4-1f Property Tax ID #: Site Plan Name: Project Name:. Lot No.�_ Block No. �J Setbacks Front Back: Right Side: Left Side: DET;AILEDy.DESCRIPTION OF WORK . _W r r ^���yzo.� ❑HVAC U Gas Tank ❑Gas Piping DElectric El Plumbing Sprinklers tt Shuers ❑ Windows/Doors �yy Generator F]Roof Total Sq. Ft of Construction: / li Q SFt of First Floor: i Cost of Construction: $ S o D , O 0 Utilities: Sewer 0 Septic Building Height: :OWNER/LESSEE �� �;; Y w"CONTRACTOR_,:: 4' Name Name: Addressss. 6 D 5`' Company `CD e " City: ` V)�e�, Stater, Zip Cod "qS % Fax: Phone No. Address:;03 I 1 City: • &% " State:-120- Zip Code:2,9 4 4149 Fax: 41e 1i- 2 /,T Phone No. //4 j- D %/ 7 E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) _ E-Mail: S�/ 6 AIS 3 D fk LCSoa Z H , Al F / State or County License: 6 D B 9 © / 5'/ '/ 3 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SIJPPLE�MENTAL CONSTRUCT O . N LAIN II�FeO�RMATIION DESIGNE NGINEER: _Not Applicable Name: MORTGAGE COMPANY: Name: _ Not Applicable Addres ✓ o rl - Address: City: State: Zip: Phone: /-pis =d >/- ii 3 City: Zip: Phone: State: FEE SIMPLE TITLEHOLDER: _ Not Applicable Name: BONDING COMPANY: Name: _Not Applicable 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. Inconsideration 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. L_A� S- rl LS Enna e„ nature of Owner/ Less e/Agent Signature V Contractor/License Holder STATE OF OUNTYOFORIDA j �C OUNTYOFSTATE OF ORI ���ic The forgoing inst ent was acknowledged before me The forgoing instrument was acknowledged before me this L day of 20I-L -by this\— ' day of �k 20 1i by (N I e�ooff�person acknowledging) (Signature of Notary Public- State of Florida ) Commission No. Revised 07/15/2014 (N W e of person acknowledging) (Signature of Notary Public -State of Florida ) - Commission No. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REV EW REVIEW REVIEW REVIEW DATE (_ COMPLETE ILo 1 INITIALS