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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COf`?.°L_TED FOR APPLICATION TO BE ACCEPTEU' Date: SCANNED Permit Number: iQ�I—�Oa I _ BY St. Lucie County RECFtven • _ Building Permit Application JAN 07 2019 Planning and Development Services Nermittlgg Department St. tucle County 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: PROPOSED INPROVEMENT L©GATION: Address: 88'80 J OGE.4AI D2., SCNSEN !/A/JT //02 Legal Description: /SLA/✓D . V.Alef L Property Tax l l7 #: 3 S'3S' - k 02 - O D ig L/ - D D D A�__ Lot No. Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: Block No. Ale YAt/KLE-rs U.// 7. UP�r2A D E ELECT/L/G AS A/EED a.. /'✓X7,_44L AJEi✓ G/irL/TiA/!r, AR6/^1sT46L NEW SL101-d (7-)77LED4�j e, eq/3/r1ET.�y _Mechanical _Gas Tank _Gas Piping _Shutters XElectric X Plumbing _ Sprinklers _ Generator Total Sq. Ft of Construction: // DDD Sq. Ft. of First Floor: _ Cost of Construction: $ 3 S , D D D Utilities: _Sewer _Septic _ Windows/Doors Roof Building Height: Pitch OWNER/LESSEE: GONTRAGTOR: Nam — /?,D,P D Lf0 LL�A/�S Name —� S/XTb .,. re)1t1e0 Address: 3D ?D -rP 8 V VCE '. Cgmpd(iY ^+• G%iz T•%Zca %4�ME� G L L' City: /414, / i State:,L e; Zip Code: .3.3JSS Fax: + CDs- 986 L3 Phone No. - 7// 'Ada'ress ,CS�9Wpi ..-cro•,nl :,s•;,r y,. ;;_! ,City::;:..ryn�'�1r:'.n;8 `�t"'�' I� —state:- -ipCo..,:� _ �... Zip�Code: 3"y�S.3 Fax: Phone No -7,% 2- V- �0-3,6 6 E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail ,JZ/NIJGD ef C4J7/Lci10 MeJ- 60/`7 State or County License If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL. CONSTRUCTION ILI MURRAMINFORMATIO ; DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address:-. ,.anx raa Address: . City: State: Zip: a i tiPPhone City: State: Zip: Phone: FEE SIMPLE TiTLE'f�OLDER: _ Not Applicable oou,,, .tE, Name: BONDING COMPANY: Not Applicable Name: 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. __) —Signature of Oydner/ ee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF .h ur Q COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this _ day of 20_ by t' at t,r f\ this _ day of 20_ by Name of person making stat ment. Name of person making statement. Personally Known OR Produced IdentificationN Personally Known OR Produced Identification Type of Identification Type of Identification Produced n 1n f I Dln.o �tXY Produced r5igKatbre of Notary Public- StA& of Florida) (Signature of Notary Public- State of Florida ) Commission No. Commission No. (Seal) .' IABFfNMAWGRAMAMMING s REVIEWS FRONT M PLAN VEGETATION SEATURTLE MANGROVE COUNT EVI REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 812117