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HomeMy WebLinkAboutBUILDING PERMIT APPLICAITON'9 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u Date: jag ` ri Permit Number: n'aG—oGO I i RECEIVED JUN 29 2017 -- SCANNED Building Permit Application By Planning and Development Services St. Lucie County Building and Code Regulation Division 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 mof%uwvs4,91A III Address: Legal Description: 0 Property Tax ID#: I',�OI— 609�—..0135_ t)OO-9 Lot No. Site Plan Name: 6'7 7-.; GW4rSo r /I✓t Block No. Sr Project Name: 5 i 6 r S Setbacks Front Back: Right Side: Left Side: O 1 Ico�C( L HVAC L j Gas Tank UGas Piping Electric 0 Plumbing []Sprinklers _Shutters O-Windows/Doors 0 Generator 0 Roof Roof pitch Total Sq. Ft of Construction: ScFt. of First Floor: Cost of Construction:$ /0,00c7 Utilities: Sewer OSeptic BuildingHeight: 0 ,NER/,LESSEE: G©NTRACTOR: NameiLMF e,o NL4X Pk OoEAZ OWxleIS� Name: -Address: 57�=�=�:2:17A7iJ�G—r IVA y Company City:• �`/ �, �'�eE=� �'=!! State: Zip Code: iknl 57-2x9 [ =P.hone'Nb.`7'7 i�rf� �{ �%3'y7 : _ ' ' Address;:I7:7-ct-. r City:r` State: Ft- Zip Code: 3ai5+1 5 r Fax: Phone No. t7711 E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail: Ar"LJ(_c4 - 4,g a , �` G9✓ State or County License: CCGL If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SURPLEMENTAL GONSTRUCfION LIEN 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: _ Not 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 rid 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 commencine work or recordine vour Notice of Commencement. Y"_ e: � ��� S Signature of Owner/Lessee/Contractoras Agent for Owner Signature o ontractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S-7, j-ycIE COUNTY OF 15 L << The forgoing, instrument was acknowledged before me this _Gl_ day of A??rL- . 20 JMby LL)del-AtNF_ -POST ne of person acknowledging) The forgoing instrument was acknowledged before me this 15k-day of h4rfi i 20 17 by (Name of person acknowledging ) ( f Nota Public= State of Florida) (Signature of Public- State of Florida ) Personally Known OR Produced Identification X Personally Known OR Produced Identification Type of Identification Prod uced�f10tiL�i <�SE Type of Identification Produced Commission No.FF14281q• ..lAV..(SEfeWISTOPHER J. FRYAIFtom mission No. Comm* =F142814 Revised 07/ 15/2014 "'4zE RSP Expires 7/17/2018 k-ULLEEN SUE HA) COW1IDS5i011 0 FF 209'. v omm� is March 15. 2019 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW RE IEW REVIEW REVIEW REVIEW REVIEW DATE �� 'I p COMPLETE 0 INITIALS