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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: SCANNED BY RECEIVED St. Lucie County Building Permit Application JUN 13 2018 Planning and Development Services Building and Code Regulation Division I ST. Lucie County, Permitting 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ✓ Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III Address: Legal Description: See- (it { lazhecf Property Tax ID #: 45-ta - yo4--cc c o - DOO -,,2 Lot No. Site Plan Name Project Name: Setbacks Front Back: Right Side: Left Side: 3&?-P+ 04P (D-F{- h1Mh fog' -P4— ©-P 10 P-�- hir 11HVAC u Gas Tank Electric 0 Plumbing Total Sq. Ft of Construction: wood -(�--nce wig Cost of Construction: $ k7, goo � (Z-k" 6-F+ w �c12, Sivtc��e,�n� Gas Piping u Shutters ❑ Windows/Doors Sprinklers Generator 0 Roof = Roof pitch Sq� FFtt.I of First Floor: _ Utilities: Sewer 0 Septic Building Height: OWNER/LESSEE. CONTRACTOR ° Name in nI[ Q✓t5!:Ln (OLO Name: I C—h In Address 75 / Company:,5ULa4- Fei c oc)mpan-si L- City: S4..Y`-F State: FL Zip Code:3 49 L7`J Fax: Phone No.�3LIW. T29 -a-FjT— **3oZ _PO rO6oti6 L&6(o City: `54LCIY`-IP Zip Code: 5*' c! ,5 Fax: ii.2 Phone No. % 7c2 - 95'9 - i )S State:--F—L -.�W'40.35 E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail: gdaLar! genre QF�etlsoc t l 6, r7 e� State or County License: aB 7 73' 1t vaiue of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL*CONSTRUCTION UEN LAW INFORMATION° ' 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, ..........---- +•.......+---. ............ I., ,u,1o, wo,u, mg; u, auceu ;uunu an❑ dccessury uses i0 anoiner non-restaentlal 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 inspegfi� you intend to obtain financing, consult with lender pan attorney before commenclnE work r61y B[DYtlln2 vnHr Nntirp of r nmmpnromant �/ Signat re of Owner/ Lessee/Contractor as Agent for Owner Signat re ontractor/License older STATE OF FLORIDA - STATE OF FLORIDA COUNTYOF- COUNTYOF Ma,+r l The forgging instrument was acknowledged before me The for�ng instru ent was acknowledged before me this�dayofs��,t e— .20M by this day of�e J26-iffby cq)e,!5kr qtchwl ncL cAe54e-r J&-hg,.4,o(-- Name of person making statement Name of person making statement Personally Known ✓ OR Produced Identification Personally Known ✓ OR Produced Identification Type of Identification Type of Identification Produced Produced 'cStaY,e_ei.Elefi (Signature of Nota (Signature o o„hnr_ ftntn of Flo . o- ..:yr: DIAf7p7Vc��E61C' BOND Commission No. Y COMA>(IgSN #FF785430 o, • .....or.: DIANE K BA? Commission - ;•: - •.,; `'?oh WC-6kF(dISSION - 5430 o EXPIRES December 28, 2018 ":pFa EXPIRES December 28, 2018 rimitiftNalar eervlCe.com ani 90d16,7 � e s.- REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED n (��' Rev. 8/2/17