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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE 1 FO�U T B COMPLETED FOR APPLICATION TO BE ACCEPTED Date: U I Permit Number: SCANNELi BY St. Lucie Count Planning and Development services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: Address: & Oa0c Legal Description: Building Permit Application Commercial ✓ �.A=Wt±m Property Tax ID#:�SflSite Plan Name: yV5:5 /Af C451-� /Cd Project Name: dl u (r6 Kfe dNGiu Setbacks Front I Back: 441 1 Ril Residential Side: /Sa LeftSide: /5-0 AUG 19 2016 St. Public vvorBs Lucie County, FL Lot No. Block No. HUUILIUIIaI WUIK LU WC PC[ IUI I I ICU 1.111=1 UIIl PC[ I I IIL—u1CL.K au Lila L apply. ' � 1 1 Mechanical _Gas Tank _Gas Piping _Shutters'` ` --windows/boors" ,-Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Constructiy:: Sq. Ft. of First Floor Cost of Construction: $ d d o a y— Utilities: _Sewer _ Septic Building Height: ®WN JR,7% SE'E: CONTRACTOR: Name ti 7 e_ Name: Q6Vf1,0 ,Lf f!t/—��/ Addres . 6 t C -" Com pany:su�cl�i�i�ti�"' �/�( N G17i/�� +L a"- Cit" State _ Zip Code: 1Fax: Phone No. /_ 3 Gd Addr_ess://.2ri'� "S L 1+:'�5C r.O City: ;ew— Zip Code: S/9 J"Z— Fax:7J1-�6� Phone No 77-2- 6J 4'- %d State:%L� 1W2_ Y2 E-Mail: rVof--e— Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail /W r/, ar,',t� State or County License C/3C G 3 / 9 G %' If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL C©NSTRUC" IDN LIEN LAW IN'F®RMATION: DESIGNER/ENGINEER: / _ L h1P_ c Name: 414 _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Addre/5�s: Jc;9 rf !gza 6 Z-1-1 oa-e �+L�j/ Address: City: /-ice / Get �� Zip: 7 Phone 7.1 State: 5? S, City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name:J_ /= #2_n.%�v ,l�L�us Not Applicable �� BONDING COMPANY: _Not Applicable Name: Address: 39u u d Ego -e &0' Address: City: runt 6.eAe e �/ P- City: Zip:i VC, g.y Phone:?7Z- W/-_ oo 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 commencing work or recording vour Notice of Commencemente'i — 17 as Agent of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF ���ClCZ1t� COUNTY OF Q4l✓oc e The for instruffient was acknowledge before me this y of 20j� by (Na of person acknowledging )/ ` 6 (Signature of No ublic- State of Florid ) Personally Known OR Produced Identification Type of Identificatio Produced BRENDA J. KEENEY 'o" . `° ( �� Mte of Florida y D&rn .bExx�@@ resaJul 22I2017 Commission No. CommisSsi9A # FF 004851 "'0��t•`P� Bonded Through National Notary Assn. 1:1�y11�1D67 RECEIVED The forgoing instru ent was acknowledged before me this day of fX1.LA4C 20/G by [�V7'd P fQ,1d) (Signature of Notary Public- State of Florida ) Personally Known OR Produced Identification _ Type of Identificati Produced o�"0.Y NANCY HERRERA E-nded Notary Public - State of Florida CCommission No. _,%y omm E(giMlpct 5, 2017 Commission # FF 049374 Through National Notary n«� EGETATIATURTANGRO COUNTER I ROEVI W I S REVIEWPERVISOR I REYI W I PLANSV EVIEWON I SEREV EWLE I M EVIEWVE