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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I _ '11tr Date: /o12 117 Permit Number: I � `� OO© I SCANNED BY St. Lucie County OCT 02 2017 Building Permit Application PERMITTING' Planning and Development Services St. Lucie County, FL 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 PROPOSED IMPROVEMENT LOCATION: Address: cG v)✓ ,q -772 , �%,972 -V to 1 Legal Description: J / 4Ae ,yPi/Gi re zo 6yYA, L(' Lvc1 4Viy&71 od C'f) 11 qY—,R3jJ `J Property Tax ID #: V,22o2 - LSOO ^ O 7a6 - Oo O—.2 Lot No. Site Plan Name: Block No. Project Name: /✓y6�� .Setbacks Front Back: Right Side: Left Side: tDE�liAI�H I,-ESCRiP0t.QNCOF — /i�/`adjti� 9 ';Z� oy"e-n9"y nAC[cl� CONSTRUCTION INFORMATION: itiona wor to e e orme undertruspermit-c ec a apply: OHVAC 1 Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors Electric 0 Plumbing []Sprinklers 0 Generator Roof Total Sq. Ft of Construction: Sq Ft. of First Floor: Cost of Construction: $ O o� 'Utilities:Sewer 11septic Building Height: O.W,NERLLESSEE. CONTRACTOR: Name Layr)y c, ,%e-i✓iom Name: / rp r/f �i9r Address: 3l. 1 Companlw7VC,V aM J City: Jd4 A Gvc Je - ' State:/? .,Address;; Zip Code:.,3 y9s� Fax: A1-1A Phone No. ?71 = VO' 6>03 y .Z3{ f L< cic G- City: !c1C State: fr Zip Code: Fax: %%a- yd` 6& Phone No. 7 7,2' 6l a/16 E-Mail: t. /A Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail:. ,"" ® c5 cp b F - State or County License:.sCG (r7 //Ls'1L� If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTI©N LIEN LAW INFORMATION: DESIGNER. ENGINEER: � ; Not Applicable Name: w 'bor' `'Gvhto✓1 1C. MORTGAGE COMPANY: Not Applicable Name:'. Address: ff Q 6 Op/tuc✓� .q a Address: / r City: %'F %Crtc State: ( Zip: Try . Phone: - - /3 V✓ 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 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 commencine work or recordine vour Notice of Commencement. ISgnatu`re of Owner/ Lessee/Agent STATE OF FLORI COUNTY OF The forgoing instru t s acknowledged b fore me this, day of 20 acknowledged Personally Known Type of Identifical Commission No: Revised 07/15/2014 OR Produced FF 11563 12. 2018 s 11g5ature of Contractor/License Holder STATE OF FLORIDA jr �W COUNTY OF A. O IF, The forgoing instru ent as acknowledged before me this 01)— day of , 20 1�_ by (Name ature of Notary Pubic- State of Florida ) finally Known r/ OR Produced Identification of Identification Produced No. NIELSEN ComMmM ission q FF 115637 June_1,2. 2618 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS