HomeMy WebLinkAboutBuilding Permit Application .........._-_--_ .. ^_ --_ .... .... - -'_~�� - ~, ���~-~,_ ___--'
SetbacksAll APPLICABLE-INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
ate: -12,3 1 Permit Number:
FEB 27 3 2016
Bu. 1.1ding Permit Application
Planning and Devel6pmentServices PERIAITTING
Building and Code Aegulation'Division St. Lucie Cour.1ty, �:I
2300 Virginia Avenue,Fort Pierce FL 34982
Commercial Residen
PERMIT APPLICATION FOR*
Now
Legal Description:
Site Plan Name: Block No,
Project Name:
Front --_- R'=__-_ Left_Side,
~
itional work to be-pertormed underthis permit-check all that app.1y;
_Mechanical _GasTank _Gas Pir)iniz _Shutters
_Electric Plumbing __Sprinklers _Generator Roo
Total Sq. RofCo,nstnucton: Sq. Ft.ofFirst Floor:
Cost ofConstruction:$ Utilities: Sewer —Septic BuUdin8HeiQht:________
' .
Name Name:
Fill in fee simple:Title Holder on next page if different E!-Mail 0,--i's _)6 Lys o^ 19 rJ9 IA,-A,
from the owner 1isted above) state or County License
rfvalue of construction is Z506 or more,,.3 RECORDED Notice of Commencement is,required.
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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 Amy,
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 exemptfrom undergoing a full concurrency review;room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses toanother non-residential use
WARNING'TO OWNER:Your failure tot Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commence'm'ent must be recorded and posted onthe jobsite
before the first inspection. If you intend to obtain financing,consult with lender or an attorney b re
commencing wori or recording our N tice of Commencement.
Signature of Owner/Agent/Lessee/Contractor Sl ature of Contractor/License Holder
STATE 0FFLORIDA STATE OF FLORIDA^ LL
COUNTY OF .. 'J COUNTY OF ?� JCIi
The forgoing instr pgpT s acknowledged before me The forgoing:instrumer as acknowledged before me
this S day of 20waJJj by this r '' day of 20-14 by
ame of
,--so acknowledg` g J (Name of.person ackno ledging)
(Signature of Notaryblit-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced IdentificationPersonals Known OR Produced identification
Y
Type of Identifica Type of Identificat'
Produced �•�-' d c d /_• P KAREN S. NIEL EN
+ ar
KAREN S. NIE SEN °+� B' C mmission# FF 637
4
E4ommission# FF �ggr is i n No• �e y Commission x ires
Commission No. `� ,y� a,,,,
My Commission Expires ''�,;oF�° June 12, 2 1
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SFA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
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