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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONiti � •1 Y?�,411.., Lo i All APPLICABLE INFO MUST BE cofint � l- ED FOR APPLICATION TO BE ACCEPTED , Date: SL BYE® Permit Number: t %� �C f 7� St. Luria r!nnntv "�t`vYv 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: S Legal Description: Building Permit ApplicatO 2 5 2017 Pu "iic Works St. Lucie County, FL Commercial Property Tax ID q: (C}�_ 5 ��� DDOO Site Plan Name: pS Project Name: Setbacks Front Back: Right Side: ID Left Side: Residential Lot No. Block No. l/i S DcfaAed 6!1 ML i. ,Vlatzr.� �ync, f la�r5 byGfs7�`� I oa-, iob) /ocF /O(o, 201, 71i2, zo3, ao��:mS, Mechanical Electric i,Ilu t." tal Sq .,Ft:of Coi f•Construction: $ _ Gas Tank _ Plumbing ion:' _ Gas Piping _Shutters _Sprinklers _Generator Sq. Ft. of First Floor: Utilities: _Sewer _Septic Windows/Doors _ Roof Pitch Building Height: OWNER/LESSEE:. C©NT ACTOR: Name: .. OS ,Address:' . 3S Zzo4:1- Company: IaoC Y (%)06-S io City: /�fa �pCr� State: �f Zip Code:: 39Z9(0 0 Fax: Phone No. 77 5-(o - G%S- 3 Address:. 5Ci - � �p City: I1L'Co I�G.('�(n Zip Code: 3a-4 (oO Phone No JOk S3 Fax: g- Obi State: ip E-Mail: CJs�usc� Co l,L �I M,:a10(,I cep Fill in fee simple Title Holder on next page ( if differenk " from the Owner listed above) E-Mail irltlam — `Rto,,CL @ ctC, hoo- CO3•,I State or County License CG C ® (o L O a— , If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. 5'UPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATLIJN: 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: 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 na .unr4 nr rarnrriina vnnr Nntirp of r nmmpn rpm pnt. A �� Si nat a of Owner Lessee/Contractor as Agent for Owner tt actor/License Holder signature of Contractor/License STA OF FLORIDAF�(f t STATE OFFLORIDA{ mw T IaA O1/`FIl CO NTY 0�S�X IF COUNTY OF The forg 'ng instr4cnent w s acknowledged before me ' 'by The for gqt.ng instr ent was acknowledged before me �f'�layof1 by this of 1, 2Q( this yl .20_0 (7 me o person acknowl dg' ) (Name of person acknowledging ) C t%rurUr" Sin ture of Notary lic- t to of Florida) (signature of ary Public - State of FJoridaj Per ovally Known Personally Known 4( OR Produced Idedtificati�OT� Type of Identification f�o`.,....c",. JOLENE K. SOUTHWICK Type of Identification ; Z :, Produced MY COMMISSION #rF079740 Produced - s. E P E9 December29, 2017 � 4 ,•�•'•AVB�'�G Commission No. 15W�I Z' (SeOijyq�•..,,,••.• ' Commission No. . i4otarysemcexom �''•.,�rVEprG REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIE REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 7/lu14 /