Loading...
HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi TO BE ACCEP:, All APPLICABLE INFO MUST BE COI-f tETED FfJR-WACCEPT:,Date: r Date: Ol,1BY Permit �. Number: 1 1©� ' 03(o St. Lucie County �2-- __._— Building Permit Application Planning and Development Services U1103 a'Ion E 7 Jk- Building and Cade Regulation Division A8 2300 Virginia Avenue, Fort Pierce FL 34982 / CIAN !1f- Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Y Residential PERMIT APPLICATION FOR: ®POSED INPRO,UpEMENT L©CA�TION: Address: Legal D scription:'S+- 4Rr—T of io_r3 Amij-9 Pc 3850-3s3 4 Property Tax ID #: J .2 0 —000'~ cxo— Lot No. Site Plan Name: /lQi Block No. Project Name: Setbacks Front Back: Right Side: Left Side: Hill LED ©-SCRIPTION OF WORK: C©NSTRUC�TLON IN'FORMAT11' N; Additional work to be pertormea un er this permit—c ec all tat apply: !/Mechanical Gas Tank -'Gas Piping _ Shutters Windows/Doors _ f<Electric Zlumbing 41 T�_ Sprinklers_ _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ Utilities: _Sewer _Septic Building Height: i ONITNE /�SSEE: CONTRACTO'R: Name R2i Name: ere 634s7�"14 Addre _ Company:,DJ �- 6�4 ;. q/_ (occvin«lio yxc� _City:. 21 State: 4+ Address: IYO IN ri--S a, %r✓ City: dv, j Liccc� F41 Zip Code: 02 Fax: 3z�-% . ., - Phone�No � ..� Zip Code: j Fax: 7-7L-923-Z3// E-Mail' 0 • rayku Phone No ' iz -X/-- 36'sp Fill in fee simple•Tiije Holde age ( if different E-Mail 9L4m� fg-M'e 8 BmAKO 1601n from the Owner'listed`akp " State or County License CMG /fV 4424 -. s r If value of construction is 2500 or more, a RECORDED Notice of Cammen ement is required. >r t SUPPLEMENTAL CONSTRUCT �J LIEN LAW INfORMP,TION: MORTGAGE COMPANY: _ Not Applicable DESIGNER/ENGINEER: _ Not Applicable Name: Name." Address: Address: State: City: State: City: Zip: Phone Zip: Phone: FEE SIMp TIT E H Not Applicable BONDING COMPANY: _Not Applicable _LDER: 1 Name: f an Cisi Name: Addr s: 3 Address: City:. nct. City: a 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 is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such which 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. t'1� ^ 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 payirig:twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite bef first inspect! intend to obtain financing, consult with lender or an attorney before co nci work or r cor ur Notice of Commencement. .� ignature of Owner/ L see Contractor as Agent for Owner ignature of Contractor/Licerl a Holder STATE OF FLORIDA STATE OF FLORIDA, COUNTY OF COUNTY OF-�.Li�o . The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me thisdayof Moxc. 201-7 by this31 day of fyo, t 201� by (Name o_ person a snow edgin ) (Name of person acknowledging) (Signature of Notary Public- Stateg Florida ) (Si not a of Nota y Public- State of Florida) Personally Known OR Produced Identification Personally Known OR'Proditpci Identification Type of Identification p �t7 p a —io �%s— Z Type of Identification produced Produced V rd0 /z Commission No. + o }I��{ ITA'ELTER Notary ublle, State of Florida Commission No. (Seal) o Commiseion9 FF 153639 REVIEWS FRONT PLANS 11 VEGE `m%-S5 TASTU�F. GRAM E ZONING SUPERVISOR COUNTER REVIEW REVIEW REVIEW RE i', pSHA NA' DATE ,* Ndtary Public`- •,fay Comm. Ex State of ires•Dec Florida20, 2016 ' RECEIVED omm ss n DATE through alionalNotary Assn. COMPLETEDBonded ev.