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Home My WebLink AboutBUILDING PERMIT APPLICATIONAll APPLICABLE II FO MUST BE COMPLI� ul FOR APPLICATION TO BE ACCEPTED Date: "!'��% Permit Number: I ! 0r'�o SCANNED BY St. Lucie Countv Building Permit Applicati E® Planning and Development Services APR 2 5 2017 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: Address: ,S� Legal Description: Property Tax ID #: Z9 - 213 SS' Site Plan Name: <arn,J4 inn ? Project Name: SG„.Js orrt Setbacks Front Back: i /Js / 2- Right Side: Left Side: a,o3, a,oS�a�b t"�,pe,c`f ScceeyL S=vrC/crsur�5 _Mechanical _ Electric .,C.k 11_i;,y. riormeu unuer uus Pennn — cnec _ Gas Tank _ Gas Piping _ Plumbing of Constru,ctiph: $ � a _ Shutters Sprinklers _ Generator Sq. Ft. of First Floor: Utilities: _ Sewer _ Septic Lot No. Block No. Windows/Doors Roof Pitch Building Height: © NEB/LESS =E: G©NTRACTOR: Namel t :'o Name: -z7�7rP -M,i `'�iAA �OSf7/✓ .'Address:.• qs3� 7 oa��'.o�� Company: C/2loGiiucyeCeS �rou� City;"\/teas Qja (_ Stater Zip Code: 229 (on Fax: Phone No. 1'2— q St.C'3 Address: (Q4� DU D,Xy C tf P City: State: Zip Code: 3a-Rl0 Fax: .,Phone No 77a- SCo9 - rfS� E-Mail: o2 (�.in-Y]Qt�gl� �_q Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail sxtS e Q el(/jotel([jot rnecit' ((, Cam.,, State or County License [� r^7 e O� (02 7 If value of construction Is 2500 or more, a RECORDED Notice of Commencement is requirea. SUPPLEMENTAL C©NSTR ION LIAUNFORMATION: DESIGNER/ENGINEER:' Name: _Not Applicable I , MORTGAGE COMPANY: ' :Not Applicable Name: Address: Address: City: Zip: Phone State: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: _ Not Applicable 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 ffft inspection. If you intend to obtain financing, consult with lender or an attorney before rnmmenrir{ Arvnrk or recording vour Notice of Commencement. Sig ature f Ow r/ Lessee/Contractor as Agent for Owner gnature of Co�nn�ra or/License Holder STAT F FLORID �� STATE OF FL�Rf}4 iV N UlUI!`�1 COU OF A� COUNTYOF The ng instru nt w s acknowledged before me Nay The for Ing instru Went acknowledge4efore me 20 U by this of 20Q by this ay of � `��ti¢. � � Q f!/l �' � (LOB ��% i�/ • s , �-•,r' (Name of perso acknowle g I (Name of person acknowledging ) � I�yV✓I�]�1 ��"l �o"uruuq�.. ( Ig ature of Notary "c- tate of Florida) (Signature of No Public -State of Rk e err 9 y Personally Known Nl�:-,4ii:.. Personally Known OR Produced Ident le' ka,TAR LL ••. Type of Identification ,,'_.- ENE K. SO W 7��Oyu Type of Identification YP ? Z : �•� Produced COMMISSION #FF079740 f Produced = AU8` G ` IRES December 29, 2017 Commission No. �Ie -1 : Commission No.� Z l Na FId yservme.00m •.,��OVER REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.7/2U14 /