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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIIONP, All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q Date: Permit Number: Ploy ��73 e SCANNED BY St. Luce County RECEIVE -- - -- Building Permit Applica ion APR 3 0 2018 Planning and Development Services Building and Code Regulation Division Permitting Department 2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County, FL Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR:'�_kP7 e 60 I Address: 25_S0 f (1 fa.'�,; eitce fl. 1W Legal Description:Lo71S 2,5�,3c9arcQ 32 0 %4onS ..Su iit Property TaxlD#: - J�ia-�0cp6,- ©Oil Lot No. Site Plan Name: Block No. Project Name:© IJ V-i2 Setbacks Front Back: Right Side: Left Side: Total Sq. Ft of Construction: e ! oai r— Cost of Construction: $ IC%O Windows/Doors l" = Generator Sq. Ft; of First.Floor: Utilities: _Sewer_,_Septic Building Height: OWNER/LESSEE: GONTRAC l Name Gv o Name: -Address:2-5Sv ytS. t{;y6� / Company: i n if o City: r-(. Rf e6c-e �^ Stater/ Zip Code:3YGq,6 Fax: -7-22-146c( 00 Phone No. 772-- L-( 6 - 0 80 ,r Address: z is T� r r City: SQbo 541AM Zip Code: - 9 � Phone No 772_- 2^ Stater Fax: E-Mail cvG I cisi. Sk 0b ) P 5 vww 6 1cw. Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail State or Co ty License* C If value of construction is 2500 or more, a RECORDED Notice of Commendment is required. --1 SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable n: iMORIGAGE COMPANY: _Not Applicable _ Name:. —Name: ,„ -,�, dd'ress': Address: City: State: City: State: Zip: ...Phone i Zip: Phone: FEE SIMPLE TITLE HOLDER:. Not Applicable BONDING COMPANY: Applicable Name:' Name: _Not 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 ar 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 t first inspection. If you intend to obtain financing, consult with lender or' an attorney before comm ci g work or recording your Notice of Commencement. as Agent for Owner STATE OF FLORIDA - COUNTY 'OF Th for oing instr ment vas acknowledge aty thii D day 201, a h`d D IF (Name of person acknowledging) s,:g (Signature Person ly Kno OR Produced Identification Type o Identifica on Produced Commission Nos/ (Seal) Signature of Contractor/License Holder STATE OF FLORIDA, COUNTY OF. The forgoing instrument was acknowled ed before me this _ day of 20_ by (Name of of Notary Public- State of Florida ) Personally Known OR Produced Identification Type of Identification Produced Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW RE IEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.7/2014 I