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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLEieri FOR APPLICATION TO BE ACCEPTED Date: Permit Number: RECEIVED F1 x �� �� FEB 2 5 1018 s: Permitting Department PermitApplication t.Lucie County Planning and Development Services CANNED Building Y and Code Regulation Division `St. Luc% 2300 Virginia Avenue, Fort Pierce FL 34982 G COUnty .Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: P�tOPQSED INPR©UEMENT LOCATjI�ON: Address: O1—n 2 �j Legal Description: J\ 1) Property Tax ID #: 3 Ml 0"DUG/ Lot No._A6, Site Plan Name: K J Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DEIR#ILED DESCRIPTION OF WORK: �Cn�onn� h �i Ic�(xa`4° CONSTRUCTION tNFORMATiIONt 1110, ition Or to a pe Orme U: 11 let this permit— check k all that apply: �_M/echanical _GasTa - �sPiping —Shutters —Windows/Doors Electric e' lumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Constructior% 3ad 6 Utilities: LiSewer _Septic Building Height: OWNER LESSEE: C©NTRIaCi'OR: Name dL Name: Q Address: Company: , City: �� Stater Address: Zip Code: - Fax:' City: 01^ e...... Phone No. �I`State�7G—A�IJi Zip Code: Fax: 7a- ` E-Mail: Phone No Fill in fee simple Title Holder on next page( if different E-Mail f 0,0(0 / from the Owner listed above) State or County License Q If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. �1 11 P� � E T 'L CRNSTRUCTI � N EN WIN aRMATlO : DESIGNER/ENGINEE NoApplicable MORTGAGE COMPANY: Not Applicable Name:_Mu,%110'o'J Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: ✓ Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: Address: City: City Zip: Phone: I I Zip: 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 commencine work or recordine vour Notice of Commpnrpmpnt_ Signature of Owner/ C ee/Contractor as for Owner Signature of C tractor/Ucense Holder STATE OF FLORIDA STATE OF FLORIDA�C COUNTY OF �/* (�— C UNTYOF (A_� The forgoing instrument was acknowledged before me The forgoing instru ent was acknowledged before me this day of�(t�d — 20 by thisa�S_­day of U 20 by Name of pe _ n making statement. Name of perSoriD4iking statement. Personally Known OR Produced Identification "� Personally Known OR Produced Identification Type of Identificat, Type of Identification Produced .�-'L Produced�s�( (Signature of Notary�iP Tic- State of Florida) (Signature of ifte of Florida ) Commission No.fiYra •, ELLEN ((����,�,,HN Commission N F;�`Sti ELLEN VAUfl}dLi lorld®^N s� oi.Rlorida•No�ary Public E.*CGo270079n�o _ p ubllc Comml®Alan d8 370079 M Com��9iu dwow 22 ' 922 eta ar 22 292 REVIEWS SOR,,,PLANS VEGETATfO GROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED l ev. of Ltl/ � / l�