The URL can be used to link to this page

Home My WebLink AboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: i to s.:ca(o' 1 -OVE �} MAR 0 3 20% Building Permit Application Planning and Development Services PEP-NUTTING 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: To Select from dropbox, click arrow at the end of line Address: S22 C QrY)QaSS CCDVe 4 C Legal Description: ()C e0.A I-e,,(DrE 12 0y- 8-7Q Property Tax ID#: 'Q L) ?, Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: Re o i( r/lain cfiSc o,1neC'7r. 1 >. _ ....._._.-_., ... .�-.,..,ter.:..•� ..r-...� ...:..: ._,.._.,...._ ;; Additional work to MGasTank orme un er t is permit-c ec a app y: ❑HVAC Gas Piping EShutters Q Windows/Doors ®Electric 11 Plumbing HSprinklers 1:1 Generator ®Roof Total Sq.Ft of Construction: Sq.Ft.of First Floor: Cost of Construction:$ so a ' Utilities:❑Sewer❑Septic Building Height: �11OV1�IVfR/LI= SEE COfTRA 'f OR Name e-ACs1 1nr111A Name:�� At�me -_2WNC' Address: Sb', 1 'SDl r.sJJ\ AJ'P_ Company: _S kc,,, City: State: Address: UgtS i9re5s1.ai (,mrn-e Zip Code:J 177q Fax: A)I a City: R-"r(-e- State: Phone No. b3l- Gil- f)L'J Zip Code: 3N9� a Fax: ti 14 E-Mail: Phone No. -77a- a/(.- 595a Fill in fee simple Title Holder on next page 4 if different E-Mail.—a t )mk ;,,l c c_ )llCG 5_:/W� from the Owner listed above) State or County License: 2 L-7 9!/ If value of construction is$2500 or more,a RECORDED Notice of commencement is required. DESIGNER/ENGINEER: =Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLEHOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: 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,1 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. S Signature of Owner/Lessee/Agent Sign o Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF '57 - I-ase`-e The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged/before me this_day of 20 _by this I day of 11711761? k-6/ - 20 ��by (Name of person acknowledging) (Name 6f pe on acknowledging) w °* M�rit ILDRE1 s 3 \9 EXPIRES:Apri120 20 I FL°A Bonded Thio Budget Notary S (Signature of Notary Public-State of Florida) ( at r NotarytPublic-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced INR'P:'B�� GREG CHILBAES3 Commission No. (Seal) Commission No./ (4--1?� *eCOMMISSION 0 EE 15482 srq EXPIRES:April 20,2016 Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS u SE�PP � 11flTAevrrat LI{ l �tan � l : 5. � DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: . FEE SIMPLE TITLEHOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: Ad d ress: Address: City: City Zip: Phone: Zip: Phone: I certify that no work or installation has commenced priorto the issuance of a permit. St.Lucie County makes no representation that is granting a permit will authorize thepermit 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. -- s iiS Sig wner/Lessee/Agent Sign o Contractor/License Holder E OF FLORIDA STATE OF FLORIDA COUNTY OF �5 COUNTY OF '5 r`e The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged/before me this Cd day of fI/l�b`� 20 /by this-2—day of 46,^e �l —20 v.by (Name person acknowledging) (Name 6f peon acknowledging) * HLDREMY COMMISSION#EE 1 9 Nr EXPIRES:Apri120,20 e)�.OF FL0Bonded Tlw NOtEry 3 er (Si ure o N arOPu/ at rblit-State of Florida) ( Notary`Public-State of Florida) Personally Known OR Produced Identification Personally Known 1(_ OR Produced Identification Type of Identification Produced Type of Identification Produced �o`e'*%% . GREG.CHILDRESS GREOCHORESS Commission No. x S�J#.COMMISSION#EE1 KommissionNo.L,i=j�`/cY��F *e COMMISSION#EE 15482 EXPIRES:April 20,201 s EXPIRES:April 20,2016 mlgf a`9e Bonded N B ry UF Pit Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS