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Home My WebLink AboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST Date: FOR APPLICATION TO BE ACCEPTW, Permit Number: 0 / 1-0@43 SCANNEDBuildin Permit Application BY Planning and Development Services St. Lucie County Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential PERMIT APPLICATION FOR To Select from dropbox, click arrow at the end of line P�Ry©P,�OSED�INIRR'OVEMENTLOCATfQN:• ��`> „�� ,„, �� .�,_;�..,., ,: Address: ' `""' Legal Description: Property Tax ID #: Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: Lot No. Block No. s's{{�DE�pTAILE©�DESCRIPTIO,N�O,F WORK: � ' •� --� � -. - �,. �°- � ��°:� �'�.,� �•x;�.Rr� ._ .-.•.c+' ;.. ,,,,� rr �S _ rya - .. . �_ : ,.�y . • , . ,; .�,, PROVIDE RECEPTACLES FOR FLORIDA DEPT OF TOURISM DISPLAYS C®NStTRUCTiIONINFORM'QTION=: g Arl(lMnn;ilwnrktnnAnRffnrmPri iinriprthic normit _ rhorG—olrr nr nnnizT 0HVAC 0Gas Tank Electric 0 Plumbing Total Sq. Ft of Construction: Cost of Construction: $ 2178 Piping LJ Shutters ors L__J Generator S Ft. of First Floor: _ Utilities:nSewer Septic Windows/Doors ElRoof = Roof pitch Building Height: OW,ME AI/LESSEE '+, CONTRACT®R ARR on a State I\urnpl A Authority Robert anning Name Name: Address: 1211 overnors Square Blvd # 100 Company: manning Electric ot Vero Beach, Inc City. Ta a assee State: Address: c Ste _ Zip Code: 32301 Fax: City: Vero l3each State:_ Phone No. Zip Code: —77ZFax: E-Mail: Phone No. Fill in fee simple Title Holder on next page (if different E-Mail: mane eC a s0U .ne State or County License: from the Owner listed above) it value of construction is $2500 or more, a RECORDED Notice of Commencement is required. ..,,.r ..x�:r„„ .y SUPPLEMENTrA(LCONSTItu, � $ION'LIEN LAW INFORMATION ' ":'.. " DESIGNER/ENGINEER: _ Not Applicable , t Applicable MORTGAGE COMPANY: Name: —No Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Name: 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 bylaws rules, 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 cornmencing work or recording our Notice of Commencement. Al-\\ Signature of Owner/ Lessee/Cont1 ctor as Agent for Owner Signature of Contractor/Licens Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF� � COUNTY OF� The forgoing instrument was acknowledged before me this lli �W The f rgoing instru gnt was acknowledged before me l_^da�y of 20-Q by this �day of 20)a by � � �(V Name of person making state nt Name of person making state ent Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Ident>ation Type of Identification Produced t ` l Produced (Si re o Notary Public- State of Norida) gnature of Notary Public- Aate of Florida I r Commission No. ,•„n, (Se�IASNAHNA ommission No. (Seal) INGRAM Notary Public -State of Florid ; •= My Comm. . fair) Expires Dec 20, 20' a .,!^^•••„ LASHAHNA INGRA J PY PL , REVIEWS f4 FRONT--"Z61N COUNTER ``, Or Fo omr dedmo �F—,5UPE$VISQR_ REVIEW fission # FF 177249 5 A r REVIEW n.)`M LANS REVIEW VEGETATION REVIEW a , �: Ny S T r,,• K a tar s - stare o PER. GROW c co ^ FFF 17'2• �%�W. ,','W 1 D, DATE rr RECEIVED DATE COMPLETED Rev.8/2/17