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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO[MST BE COMPLETED FOR APPLICATION TO BE ACCEPTED -� ci Permit Number: Date: SCANNED BY RECIE ED d - St. Lucie Count. Building Permit Application NOV 01 2017 Planning and Development Services PERMITTING Building and Code Regulation Division St. Lucie County, FL 23DO Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLI—/ CATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED.IMPROVENIENT LOCATION Address: GG 5, / . 3 Legal Description: S A �� f 9441VI) Property Tax ID #: 3 S�Ur ` ©00 — Lot No. Site Plan Name: --YC r Block No_ Project Name: Setbacks Front Back: - Right Side: Left Side: DETAIL-E DESCRIPTION OF WQRIC = .. .... ' CONSTRUCTION iNFOItMATlO1V ` itiona Wor to jepeorme un er t is permit- c eCK all ha app y- �HVAC ❑Gas a Windows/Doors L_J Gas Tank Piping _Shutters Electric Plumbing ❑Sprinklers Generator Roof Total Sq. Ft of Construction: -S�-O O S . Ft. of First Floor: r Cost Construction: $ • 00 Utilities: Sewer Septic Building Height -S 7c of i _S—DO OWN.R/LESSEE CONTRACTOR' Name Name- C� Address. Company: City:, State: Address: �. Zip Code: Fax: City- State: Phone No: Zip Coder Fax: E-Mail: Phone No. Fill in fee simple Title Holder on next page (if different E-Mail: ` from the Owner listed. above) State or County License: If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPCEIV4ENTAL COIVSTRIfCTIONtIEN LAVA 1NFC4RMATIOfV DESIGNER/ENGINEER: _,Not Applicable MORTGAGE COMPANY: _NotAppiicable Name: Name: Address: Address: City: State City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLEHOLDER., _ Not Applicable BONDING COMPANY: _Not Applicable Name: 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 orrecording your Notice of Commencement. s _ Signa re of Owner/ Lessee/Agent Signature of Con or/License Holder ST TE OF FLORIDA �/ STATE OFORIDA V l r I I� COUNTY OF I / I The forgoing instrumelitwas acknowledged before me ✓• 201�by The fo�ging instrument was acknowledgedbefore me this iiday of /clot/. 20 7 by this day of No -�!S- alp�' a 1445C&4 - (Name of person acknowledging) (Na of person acknowledging) f X (Signature f No ry P Ic- t of Flo da ) (Signature of NotaryIlc-Sae of a�— Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced Commissio No. VARM VjpA FRAW �►i Commission No. Seal Now DUAME PRM ~� lyj 71' 1011 ~ n play?, 2027 WUMEXPR Revised 07/15 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE REVIEW REVIEW COUNTER REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS