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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI All APPLIC L INFO SCANNED Vo_ MPLETED FOR APPLICATION TO BE ACCEPTED' I 4 _ Date: Permit Number: '� -- - BY W� - St Lucie County -- - Building Permit Application �(S1 Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial __W_ Residential PERMIT APPLICATION FOR: KROP�OSED INPRO.u€MENT LOCATjiON: Address: ©�( a5 S• � c m i er r/�c✓a��2Dr"f .S-C. 4r 4:7�_ Legal Description: Property Tax ID#: SDD`C 4110b ( (Q(o -O Lot No. Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: _Mechanical' _ Electric _ Gas Tank Plumbing Gas Piping _ Sprinklers _ Shutters _ Generator Total Sq. Ft of Construction: _ 3D Sq. Ft. of First Floor: _ Cost of Construction: $ utilities: I Sewer —Septic Block No. —Windows/Door's Roof Pitch Building Height: OWNER/LESSEE: CONTRACTOR; Name L — L Name: Address:_pZ-/�(2�l�% R(N S`t• Company '-LS fitn i City: L( F A ( O State;(t2'� Zip Code: IV 4( I Fax: Phone No. q-5`� a /3 ?j (o-7� Address. 6DC Awn GL 9 City State, Zip Code: Fax: Phone No r E-Mail: l r .SZ`Ori c- C :. Fill in fee simple Title Holder on next page (if diffe .6ni' - from the Owner listed above) . ,_ :, E-Mail J 'c/ raj �yGtEY LDtl-I State or County epc_ (-,iio o3a9 If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL G0RTRUCTION LIEN LAW INFO MATION: 'DESIGNER/ENGINEER: _ Name: Not Applicable MORTGAGE COMPANY: Name: _ Not Applicable Address: Address: City: Zip: Phone' State: City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: _ Name: Not Applicable BONDING COMPANY: Name: _Not Applicable 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 commencing,vt ork or reeordinia vour Notice of Commencement. ll Agent for Owner Holder STATE OF FLORIDA ' STATE OF FLORIDA COUNTY OF. l�� %�C�t�_ COUNTY OF \ I The f ing instrpiagnt was pcknowledged before me The fpAl ing instr ent was cknowledge efore me this day of by this day of 20y C2 -cam C' C (ITa-me of pehon cknowledging) ^ (Name of person ack owledging) I (Signature of Nolftry Public- State of Florida ) Personally Known OR Produced Identification Type of Identifi a1;io Produc �,,ti;F.>"gym, ANGELA M HUFF Commi o�No State of Q3' FF 234730)5'••'s May 27, 2015„ Public- State of Personally Known OR Produced Identification = Type of Identifica Produced "IvutLA M HUFF .I e��o• �`�= Notary Publicr of Florida Commission No. _' • •; 0mmisslad34730 My Comm. Expires May 27, 2015 Ban dedrhr„... , roug abonal Notary Assn i�- REVIEWS FRONT ­70NIN— SUPERVISOR PLANS VEGETATION SEA TURTLE-u MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.