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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE CON Date:- 17FOR APPLICATION TO BE ACCEPTED Permit Number: SCANNED BY �+°' o St. Lucie County Building Permit Applicai Planning and Development Services - Building and Code Regulation Division ST. L 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial >/ Residential PERMIT APPLICATION FOR:, We' bvv\ (�vvecJ� 4,n�n Address: — Legal Description: Property Tax ID #: I Site Plan Name: rTn/ Project Name: Setbacks Front Back: .9 5 RightSide: (/' A197- Left Side: 40- rA ttUIVED JUN 19 70sg Lot No. Block No. Haanionai worKco De perrormea unaerims permn-cnecK au Mal apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator _X Roof _ 3 Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: _440 i�t Cost of Construction: $ D t'l D. D CJ Utilities: —Sewer %Septic Building Height:_ ©WNE /LESSEE: CONTRA�+�OR Name: � tJU�\ nU Company: I� �d.S �ytiSi(cF��cil City:State Address:L it e-- City: f:o0- P State:l_L Zip Code:j3%N-\LN1 Fax: Phone No. - _ _ Zip Code: %Lt CL Q % Fax: E-Mail:, r ` _ _ Phone No -7 �J- Z S- Lt (,- E-Mail &eroa,✓l Mai, �. Cu Fill in fee simple Title Holder on next page ( if different State or County License 16' from the Owner listed above) If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. ro DESIGN ER//ENGINEE R: _ / / Not Applicable Name: 0/�/t/ Address: f City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: _ Not Applicable MORTGAGE COMP N_ Not Applicable Name: / Address: City: _ State: Zip: Phone: BONDING COMPANY: _Not Applicable Address: Address: City: City:_ Zip: Phone: Zip: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit io 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 stt&cture 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 ray 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 additilns, 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 STATE OF FLORIDA � RECEIVED COUNTYOF11�I�Y/' SEP 0 41018 The forgoing instru ent Vlas acknowledge ,i��7,•efore me this � day of 20 I byPerst. Lug Depart) St. Lucle Counl 'JC12. X -_ K/ k; Name of person making statement. Personally Known OR Produced Identification Type of Identif{c�tio Produced I -( Yin 124� (Signature of Nary Public -State of Florida Commission REVIEWS DATE RECEIVED DATE COMPLETED awIc Ui wuu�a� wi�u�cu c nuiuc:. STATE OF FLOR DA COUNTY OF� The for oing instru ent was acknowledged before me Zhis - day of f n20-E by L 1-n V i'c�tS�r,... Name of pdrson making statement. Personally Known l/ OR Produced Identification Type of Identification Notary Commission No. CO—UNy ER � ZONING REVIEW EW SUPERVISOREVIEW R REVIEW VEGETATIEVI WON iX111111ON # UG26M EXPIR pt tA2200222 SEA TURTLE REVIEW