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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FORIICCEPTED Date: "' 2®�� Permit Number: LIAR 0-12016 •`-sem. �:;z;.�-� �� .,ft-i.':.=-c '-rta- �'1 C _ PERMITTING St. Lucie County, FL �. t Building Permit Application Planning and Development Services PEWAITTING 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: PROPOSED INPROVEMENT LOCATION: Address: �,�5 CSO 'G 14 '4 IV Legal Description: Property Tax ID#: I �Jd (o? q B c�q S -0 6 o ~ Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: l ag�N D t-J ©we1Z . F-e_P 1)4C-e rp (�ec.e ell �S Sw rk-4a e_p rr+c� - �A►a CONSTRUCTION INFORMATION: Additional work to be pertormed under this permit-check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors �ctric —Plumbing —Sprinklers —Generator —Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ C)b . Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name n,eS 9;VCVP---'SS Name: Address: 6;2O 7 t-eNTle' Cke&-e Company: City: � Poe recC State:-EL Address: Zip Code: 3L(9S1 Fax: City: State: Phone No. _S-?G- 6-3q-( /9L Zip Code: Fax: E-Mail: C 4,&,4/V40$- O e!!2w1 cx-t,7`, Ne-7` 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. . - � SUPPLEMENTAL CONSTRUCTION UEN LAV1J 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: 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 recording our Notice of Commencement. %r. cam__ Q�_� Sign ture of Owner/Lessee/Agent Signature of Contractor/License Holder STATE OF FLO DA STATE OF FLORIDA COUNTY OF Lu %- Co COUNTY OF The forgoing instrument was cknowledged before me The forgoing instrument was acknowledged before me this day of 20 1,e by this day of 20_ by ( me of person acknowledgin ) (Name of person acknowledging) (Signature of Notary Public-Sta a 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 Produced IFL, `1�Y ""DKAREN S. NIELSEN ` pY �<,' Commission No. j '; ) Commission B FF 1( Fnl ion No. (Seal) My Commission Txpires June 12, 2018 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED re—v—.7/2014