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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ii Date: �- (0 �- 1 Permit Number: 65�w" 00KO REC.,EIVEIC - Building Permit Application AUG 10 2015 Planning and Development Services PERM IT°i i' Building and Code Regulation Division St.Lucie CO-lint-Y, 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential ✓ PERMIT APPLICATION FOR: PRt*)71 7SED 1N'PR O VAEMENT LOCATICyN: Address: 9565 r1 orenCe "DR Por+ SL G. uG/2 EL 3`-9Sa Legal Description: Property Tax ID#: -�,qoZGto(,400(a o600is Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DExSCRIPTI©N F WOR+K; `}(oice ozn '6X- I QL shed in hco L corner' C0 :STRUCTION INF®R�MATION: Additional work to be performed under t is permit-check all that appy: _Mechanical _Gas Tank _Gas-Piping _Shutters _Windows/Doors /Electric _Plumbing _Sprinklers _Generator _Roof i Total Sq. Ft of Constructions: I Sq. Ft.of First Floor: Cost of Construction: $ / / / ' DD Utilities: —Sewer _Septic Building Height: 01A/N ER/LESS€�`E: °CONTRA�T®'R. N a m e'-P o ec-+ Lc>w(Yi '1 Name: Address: $S(05 'P�orQnCIZ DY' Company: City: Pof + S+ (_c �I C_ State: EL Address: `u Zip 34-95 Zi Code: � Fax: Cit State: Phone No. 7 ?a - ad-7- 7 I a g Zip Code: Fax: E-Mail: eoa_ck 10 0 1I UGC ,com Phone No Fill in fee simple Title Holder on next page (if different E-Mail from the Owner listed above) State or County License tt of construction is 2500 or more,a RECORDED Notice of Commencement is required. S~ �Pi.EMEN FAL CONST �UCTiON LIEN LAW (`NFOR'MATtON: 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: 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 rEXording your Notice of Commencement. ature of Owner/ essee/Agent Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF ��-.�.we:c COUNTY OF The forgoing instment was acknowledged before me The forgoing instrument was acknowledged before me this_.day of . 20J&' by this day of 20_ by (Name of person acknowledging) (Name of person acknowledging) &�h-h-im'— ignature of Notary Public-State of Florida ) (Signature of Notary Public-State of-Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Producedli7L.Q'ui�- L ;SF3 CA0-C) Produced .a . LA AHNA INGRAM Commission No. .`��"�P�e�;,,, ��cc Commission No. (Seal) Nol9 i blit-State of Florida My Comm.Expires Dec 20,2018 WOW r: n #FF 177249 REVIEWS FRO o edthro ghN44, Notar Ass . PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.