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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE tivMPLETED FOkAPPLICATION TO BE ACCEPTED i(� {� Date: SCANNED Permit Number: I -1 I BY St. Lucie County RECENED MEN Building Permit Application SEP 05 2uis Planning and Development Services permitting Department Building and Code Regulation Division st. Lucie county 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: 6NCj )&at4lf�0AJ Address: Legal Description: I V I U-4 C7e LJMI+ A 3yyz) Property Tax ID#:_LlLlZZ- 865'00Irl^OOo—I Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: _Mechanical _ Gas Tank _ Gas Piping Electric . ZPlumbing _Sprinklers Total Sq. Ft of Constru&tion: .2500 Cost of Construction: $ Lot No. Block No. _Shutters Windows/Doors _ Generator _ Roof Pitch Sq. Ft. of First Floor: Utilities: _Sewer _Septic Building Height: ©WNB /LE —B CON J1 I iOAR Na Name: D Q t Address: Da W WIA14.5 Creek, A Company:RA., \J ,rJ J i,kwa!L-eLes =nfc City: PA6" State:, Zip Code:3C( g q Fax: PhoneNo, l'12' WSJ" y2-6!5 Address: A IT(or- 6444e( City: a400 Ar nJ State. Fl- Zip Code:33i^/Z$ Fax: Phone No _Sol' 576-5tol91 E-Mail:I1NO(4.5ikl lc4Ak @, b-a((9Q, Ut , vJek- Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail I'?NdyA I iOd l •4ec (n i Ne @Y4 (W 0 Cam' State or County License G G G 15 ZZ lfl 31 f it vaiue of construction is Z5oo or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION_ LIEN LAW INFORMATION DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY. _ Not Applicable Name: 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: Zip: Phone: I 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 az 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 roams 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WiTH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signature of Owner/ Lessee/Contractor as Agent for Owner Slghatur6 of Contra o License Holder STATE OF FLORIDA ^ kV+L r) STATE OF FLOR AINt COUNTY OF I COUNTY OF . The forgoing instrylne�m was acknowledged before me The forgoing instrument wa acknowledged before me I(iik this � day of D�J 2012 by this by of �JJ 20\1 by L•lnda SInI�t,.�G ��zna- (�e(�s�r2J�, Name of person makings tement. Name of person making statement. Personally Known OR Produced Identification Personally Known V OR Produced Identification Type of Identification Type of Identification Prod ed Produced 7 lgna a of Notary Public- "✓1 Ofly'+ owtature of Note LY5HIA HOUON }p _ j : Public Florida Commission No. €(S'�°�I 6 GG 106175 'y� NoteryPuhlic Stale of FlofiOe ys' Abigail Ii Ra¢ liar ommissic No. 9a b mission •!Fonra,'.•" My Comm. Expires May 30,2021 M, yConsiss n 225260 i,�orn� Expires 0610512022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED .Rev.2/7/19