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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO Date: BE COMPLETED FOR APPLICATION TO BE ACCEPTED �7 SCABN1NEQPermitNumber: "© St. Lucie County RECEIVED Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: Address: Legal Description: Property Tax ID #: Site Plan Name: Project Name: Setbacks Fri Building Permit Applicat on APR """ 5T. Lucie county, Permitting Commercial. Residential Back: Right Side: Left Side: Lot No. Block No. Mechanical _ GasTank • ' _'Ga's Piping —Shutters _ Windows/Door's �cElectric �CPlumbing —Sprinklers —Generator Total Sq. Ft of Construction '937 S ,F Sq. Ft. of First Floor: Cost of Construction: S tilities: Sewer Septic Roof Pitch Building Height: OWNE /LESSEE: GONTRAC«TOR: Name N Name: E WclAaw"kO Address-: k — tr iydil/ Cc r'c, Company W keyv,//a/ Pawt-P �itilD!'�I P City: eV -A— ,SA-- Zip Code: 2 C19 re 7 Fax: Phone No. %�% �G' 3 � 0�4l State: Address, 1'—UeyGPI'a City: --fe HS/H ec" C I- Zip Code: a I��� Fax: Phone No�7 7 D 3?0 - C/ri.37 State: �C E-Mail kOU r ✓Y cf4lW1 (P-1 Q ydc/. CMr, Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail a l C(- State or County License ' I r y If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. f.. SUPPLE =NTAL GO 5T ` UCTIQ LIEN LAW INE()RMA� 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 concurrenry 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 work or recordingour Notice of Commencement. ev. Cl REVIEWS FRONT ONING SUPERVISOR PLANS VEGET SEA Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF [A-)� COUNTY OF The fo going instr ent was acknowledged efore me this�dayof 20�by The fo oing instr ment was acknowledge efore me this �day of. .�YlI lkiw,r AC.I���►�,� .20�by f Alt1A,�Yl� (Name of person acknowledging) (Name of person acknowledging ) (Sig ature of Notary Public- State of Florida j (Signature of Notary Public- State of Florida j Personally Known OR Produced Identification ersonally Krtown' Produced Identification Type of Identific ion SEtd ype of Identi on Produced SN e3 �F >j5 s oduced � �/,� K mREN \ss�o" sio^ ExPice Commission No. (jomn"s go�B mission No. I<AREN S. �19 10 issioo 2 My GR