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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: (ISM- r IV E - Building Permit Application AUG 19 2015 Planning and Development Services PERMITTING Building and Code Regulation Division St. Lucie County,FL 2300 Virginia Avenue,Fort Pierce FL 34982 . Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: PR �POSED INP'RCIUEMENT' LOCATION: Address: Sb b Legal Description: 1-9-- 4Izf w�A p4z k' / 8 B Property Tax ID#: Lot No. Site Plan Name: Block No. . Project Name: S Setbacks Front Back: Right Side: Left Side: DETAILED DE�SCRIPTL�'N C�3F WORK: h CONSTRUCTION INF©R,MATION: Additional work to be pe orme un er this permit—c ec all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of ConstructiX1z'1'D'WT1 111110 Sq. Ft.of First Floor: Cost of Construction:$ Utilities: —Sewer _Septic Building Height: OVIlfiIER/IUS&EE: � CONTRACTOR: Name 0 C--� Name: Address: i S Company: City: State _ Address: Zip Code: Fax: City: <;: °' _ State: Phone No. Z /� / Zip Code: ax: E-Mail: x^32 �� Phone No Fill in fee simple Title Holder on next page/(if different E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. S'tJPPLEMENT' L CONSTRU_GM0, �IEIN 11 4W IN'�ORIVIA►TION: Wawa=;, 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 befo 'rst in ec ion. If you intend to obtain financing, consult with lender or an attorney before c mencin w rk or recordin our NDti_ce-af-Gernmencement. e of Owner,/Lessee/Agent Signature of Contractor/License Holder S TE OF FLORIDA, STATE OF FLORIDA OUNTY OF COUNTY OF The forgoing um rgoing inst ent was acknowledged-before me The forgoing instrument was acknowledged before me L this day of CJ 20 16 by this day of 20_ by (Name of pf son acknowledging) (Name of person acknowledging) Signature of Notary Pub ic-State of Florida) (Signature of Notary Public-State of Florida ) Personally Known OR Produced Identification i Personally Known OR Produced Identification Type of Identification Type of Identification Produced FLiJ,\Jg-lam° 1ko- 1`1(940• Produced Commission No. ( a Commission No. (Seal) �ASHAHNAINGRAM State of Florida •�o°R ��••, o EX iresDer 7 49 -, REVIEWS FR Ri . Imissi r6#1l , PLANS VEGETATION SEA TURTLE MANGROVE COU o 0 1hrouA Nat �"�: REVIEW REVIEW REVIEW REVIEW DATE ,,. RECEIVED DATE COMPLETED ev.