Loading...
HomeMy WebLinkAboutBUILDING PERMIT APPLICATION�� lam.-L� ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED {� n Date: SCANNED Permit Number. BY -" St. Lucie County Building Permit Application Planning and Development Services Building and Code Regulation Division 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 Address: Legal Description: 0 Lft per t46 %j i r_�_V tilr1F�) (6A 4aq.) -a�) ' Property Tax ID #: lya9 -SCO -cW8 "- 040 17 Lot No. Site Plan Name: Block No. co Project Name: Lbw tC P Setbacks Front Back: S Right Side: 10 Left Side: HUUILIUIIOIWUIRLUUC 11HVAt" CIIUIIIICU Gas Tank UIIUCI LIIID �lCIIIIIL-UICLR OII Gas Piping _ G�IPIY. Shutters 11 Electric Plumbing []Sprinklers Generator Total Sq. Ft of Construction: Cost of Construction: $ '0-, 00b S Ft. of First Floor: _ Utilities:0Sewer D Septic ❑ Windows/Doors Roof' = Roof pitch Building Height: DOWNER/LESSEE; sN CONTRAC�TiOR• Name P es �-L'. ame: leh �it.c &J WIZe 71"rAA.e(�s� /�'`DVEF Address: 01:� WO Company: *bALMb q.01AA)&- City: DRY- jeR09- Zip Code: 3L1999 Fax: Phone No. %�_Iy6 y a3 %8 State: %ia-yb4-03, � Address: -7 ESE _rO? -rZL City: Voe-t- P:�ru Zip Code: 34,i 51 Phone No. -7'7Z - State: L Fax: -772- J4&z170_ZZZ G(8 - 36-7-7 E-Mail{ )%.Ar-Cac6kmae'ofit4'coYn Fill in fee simple on next page ( if different from the Owner listed above) E-Mail:7Co Q'ba t(e�c.s °"'>z • C1�M State or County License: CGO / S2y�J0 !;cc goo L If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPFLEMENTrA'LL CCONJTRU TI®N LIEN LAW INFORM,A�TI©N: DESIGNER/ENGINEER: _ Name: �}mA1- _C-+0AI%c.-S 'Znrc. Not Applicable MORT G CO PAN Name: S R _ Not Applicable nIL Address: 006 ba-lauwr, Aun Address: s Rd City: T;,+ V'r-rce Zip: 349 50 Phone 772: State: :rL, 7460 . J75 t City:/ ,eite-a — Zip: 3y�L?.:). Phone: State: rt 7i2 - a93 -0636 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 Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in contlict 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 perty. A Notice of Commencement must be recorded and posted on the jobsite before the first insp9dicin. If y ,pianintend to obtain financing, consult with lender or an attorney before commencin work r rcordAg,your Notice of Commencement. 4�41 Signature of Contractor is older Signature of er/ Lesse K ontractor as Agent for Owner STATE OF FLORIDA STATE OF FLORIDA - COUNTY OF clk L ur COUNTY OF St l va r The for oing instrument was acknowledged before me day 0 by The for oing instrument was acknowledged before me this day of 00C 20'�,by this of f k 26 �Ehcss Name of persop making statement Name of person making atement Personally Known,, OR Produced Identification Personally Known \ �/ OR Produced Identification Type of Identification Type of Identification Produced Produced n 1 1 (Signature of koj—ry' 'sit9lt*09R1DGES (Signatur ota Pub1c-State of I ' z Dommisslon k GG 022072 Commission No. plresSOWber13,2020 Commission No..,.>� 'y,,JANAL.BRIDGF� k G >3��2 ' tttgp'' 9onananwrrnFamwua�eaoaesmte , sslon September 13,2020 n „Expires M3 �{t,u BQrAWThrUTrGY lnswance901H85'7019 key REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED O Rev.8/2/17