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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BYY MUST BE COMPLETED FO APPLICATION TO BE ACCEPTED �7 Date: id-gi—IO s APermit Number-* YL9' ,s..E- - St. Lucie CountyRECEIVED Building Permit Application JUL 3 2018 Planning and Development Services Building and Code Regulation Division Permitting Department 1300 Virginia Avenue, Fort Pierce FL 34981 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial < R sid&iir{u c i e Count yr F L PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of lin PROPOSED IMPROVEMENT LOCATION: Address: $ `? Legal Description: Property Tax ID #: Lot No. 1 f Site Plan Name: 001 V5 (it' HA- iKCf t-LBlock No. Project Name: (•9 IQ-40 Setbacks Front Back: Right Side: Left Side: r-b" DETAILED DESCRIPTION OF WORK: nS�cn\l 6� °Jraaac }sap �. C0NV-Lt40r\ kO ��P s rare CONSTRUCTION INFORMATION: Additional work to ,Ie_lperformedunder this permit- check a apply: ❑HVAC LI Gas Tank []Gas Piping _Shutters ❑ Windows/Doors ❑Electric Plumbing []Sprinklers ❑Generator ❑Roof ❑ Roof pitch Total Sq. Ft of Construction: Sc Ft. of First Floor: Cost of Construction: $ � Utilities: Sewer El Septic Building Height: OWNER/LESSEE: CONTRACTOR Name: fff Name %41?\J \ Address: `ti$ Z rJ wq Company: QSA`P/L City: 1 p/lCQ 5 ate: Zip Code:.3 % 5 i Fax: N PhoneNo.3o�i- o�tyn- 3rJ22 1()Vi`IP— Addres�j:'%3%� UIS TtW 1 / City: r V � t_ 1 O(A f. State:I•r ZipCode:3qr15%i Fax: Phone No.122-595'GJ19O E-MaiI:�PV1VL517( Iy�yj I)Q1,4 .P©VYI Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail: State or County License:/�n i If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Name: _ Not Applicable MORTGAGE COMPANY: Name: _ Not Applicable Address: Address: City: Zip: Phone State: City: Zip: Phone: State: FEE SIMPLE TITLEHOLDER: 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 work or recording your Notice of Commencement. 1�. ' 1tx .0 •Owner% Llesse /Contractor as Agent for Owner Si ri ,#IiceLof C•antrect9 •/Lfcen'selHolde`r STATE OF FLOR A STATE OF FLORIDA COUNTY OF Luc I-e— COUNTY OF St . LLAc Ir-_ The forgoing instrurgent was acknowledged before me this � day r 20! by The for Ding instrument was acknowledged before me this day of 20S by of Lt -c- 4L'! _ Name of perso aking statement Name of perso aking statement Personally Known---AR-Bre Personally Known- OR Produced Identification Type of Identification LINDA C COLLINS i Type of Identification Prod �`- . v MMISSION n FF192590 Produce EXPIRES March 09. 2019 J. F4a+InNo••r r�0..¢a con (SiNature of Notary PulblicQate of FI 1 '1� A C COLLINS (Signature of Notary Public- Stag o_ rl LINDA Commission No. ` My C("IFSION q FF192590 ; ....r.. C COL Commission No. �SL�1pOMIv11SSION p F � �'•..a EXPIRES March 09.2019 • • EXPIRES Mard109• . Nyir,q. h4 .4Nq•a Sc.. r(u con tl •r REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17