Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPL711- BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q Date: Ito Permit Number: U RECEIVED Building Permit Application APR 1 1 201 Planning and Development Services PERIAlTrING Building and Code Regulation Division Si- Lucie County, FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential 4' PERMIT APPLICATION FOR: PRU'OSEQ INTRO 07,1119,'TLO/CA tO : Address: <3'-/QY �L,rJ'Z +"eld tz' y R54 �7 eP4 Legal Description: Pop pt 7 AT AeSe2,)e X irz a kt Reog-4t A e5 2 g � Property Tax ID#: �j�� �o�� �y.3'� – Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DE�SCR�I'PTIDN 00 WORK• �Y���e,�t- � yam� :�o�L�• ��; �®�' ItCO',N'SlTl=lllNIP.Q'R,I,M',A ION: Additional work to be performed under this permit–check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ Utilities: _Sewer _Septic Building Height: 001,15,PER/LUSEE: MaNTRACTO.R� Name — .e Name: �� 711l�c.'S fw�n�i'xe Se�.a'v�ir,tit,L Address:g,z/ AjAhclez fir/ Company: !�G(�!c.• � City:AS,�Jx�C� I Y State:/ Address: /� _ Zip Code: ~3 Fax: City: Stater Phone No..� �-�G'�P� Zip Code: Fax:X729VG?f5'1< E-Mail: Phone No f`,72�" 31G-4%eeel4° Fill in fee simple Title Holder on next page (if different E-Mail o c ,fl�c�syslik,cTTi.C�r from the Owner listed above) State or County License if value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SU PLEMENTAL CfJN�TRUCTI©N iN LAW FaRMATtO 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 comm in ork or recording our Notice of Commencement. Sig ure of CVvnerl Lessee/Agent Signa re of Co ractorAicense Holder STATE OF FLORID ` STATE OF FLORIDA COUNTY OF 1. 0,1F, COUNTY OF / • {AJCII✓ The forgoing instru ent was acknowledged before me The forgoing instr ent was acknowledged before me this day of 20� by this day of 20 by (Name of person acknowledging) (Name of person ac nowledging) CAP AA \ (Signature of Notary Pu lic-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 Identific tion Produced Produced !✓, DL- KAREN rL-KAREN S. NIELSEN Commission No. I a° (6eal)nission# FF 11563 C mmission No: -� *_ S. NIELSEN My Commission Expire Y'r4P; KAREN i l�tlP llO`4 June 12, 2018 - Commission#FF 115637 dp E MYomm e 1 2. 2018 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATI COUNTER REVIEW REVIEW REVIEW REVIEW "R W REVIEW DATE RECEIVED DATE COMPLETED F A ev. 7/2014