Loading...
HomeMy WebLinkAboutBUILDING PERMIT APPLICATION1 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: S — oIN— / 7 Permit Number: `0C/ SCANNED BY St. Lucie County tmu I Building Permit Application AUG 0 0 2017 Planning and Development Services PERVAIl-NNG Building and Code Regulation Division St. Lucie County, FL 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: PROPOSE© INPR©UEMENT LOC»-ATIC(1N: 1.I.Iroee• �i �%_S/ S 7_Sf� J% Legal Description: Z 9 / 355� �o/U� %y - /Css Z90 �f ,�47 3So r ll SS ^1g Co / a Se CAor� r�e�A 5'. z`%O Property rax ID a: Z `/ Z 9—/ 1! -- a e o 3— 00 0 — s Lot No. Site Plan Name: �//� o/rq l7GS Block No. Project Name: )j/LUL 1 3_ Setbacks Front Z / Back: A,', Right Side: /V,* LeftSide: N� _Mechanical _ Gas Tank _ Gas Piping _Shutters —Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: ' Cost of Construction: $ 3,100 Sq. Ft. of First Floor: Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: •ON R,,MOR Name A Name: q " e2 fS Address: Company:ST-` W�11 S� �SSo c City: Stater Zip Code: r; Fax: Phone No.56/ ,5'e// 'OZo Address:776p S 1-1646 1 l�Gita City: /T (� 1-/ce Zip Code: 9 e/ 4— Phone No 77Z $`ZS State:�G Fax: —//30 E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) - E-Mail State or County License G/J 16 If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. Name: City: Zip: Phone State: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: _Not Applicable Name: Address: 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 Commencement. as Agent for Owner STATE OF- FLORIDA COUNTY OF The fgfgoing instr merwas acknowledged before me this 1( day of . 201 h by (Name of person acknowledging) , of Notary Public -State of Signature o ontractor/License Holder STATE OF FLORIDA COUNTY OF The f oing instr n was acknowledged before me this y day of 20by (Name of person acknowledging ),\ of Notary Public- State of Florida ) Personally Known OR Produced Identification V Personally Known OR Produced Identification Type of Identification Type of Identification KAREN S. NIELSEN Commission Nosion & FF 115637 y co. `,_ C Commission Expires �'%�',p•_... June 12, 2018 REVIEWS CFRONT ZONING OUN ER I REVIEW S REVIEWOR RECEIVED DATE COMPLETED No. IC EN S. NIEL: �ue��=_ `C om -ission N FF 11 My Commission Exi PLANS REVIEW I VEGETATION EVIEWSEA REVIEW LE I MANGROVE