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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I Date: '1. O P Permit Number: l RECEIV ED -„ k APR 10 2016 Building Permit Application PERMITTING Planning and Development Services St. Lucie County, FL Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: O 44 PROPOSED IN _k EMENT LOCATION. . Address: 517+ TRZF_zT°pTKAJL FT FJE?,d_-_ f • Legal Description: Property Tax ID#:J � � � � )0 2t 0 M - 0 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK TG T'094Z ' P0,0e, I UT—= F6K 60AJ6MucT10u OF �J1=u7 Hop1 To > F4_MDUr-D1yP©�� �d Mi' r I oN OF Hones CC*NSTRUCTIC3N INFOR11tlATIOyN Additional work to be pertormed under this permit-checFall that appy: Mechanical _Gas Tank Gas Piping _Shutters _Windows/Doors 7Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ �� Utilities: _Sewer '—Septic Building Height: OttUNER%Ll#SSEE CONTRACTOR , 4 Name P/AvID Y6vP6 Name: E 1Z rkS Address: 5174 T�TDF TFL Company: � TRIS UL City: f: , State: FL- Address: t W60D l Zip Code: 3"51 619 Fax: City:Fo�F0= State:,' Phone No. (TZ.) 61$-36V Zip Code: _0951 Fax: E-Mail: Phone No (772) 571-2069 Fill in fee simple Title Holder on next page ( if different E-Mail 5W5M 1`T5`-YA8W,60n from the Owner listed above) State or County License- If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. Sl1PRLENIENTALCONSTRUCTION LIEN„LAW WFORMATIC3'N 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 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 wo or recording our Notice of Commencement. A Signature of Ci Le ee/Contractor as Agent for Owner Signature of Co or License Holder STATE OF FLORIDA , STATE OF FLORIDA COUNTY OF I E COUNTY OF (J�/ The forggoing instru ent was acknowledged before me The for oing instru nt was acknowledged before me this day of 20_L6by this day of 204 by \ E—:VGC ffiJL-V& A Q Q (Aame per acknowledging) (N me of person cknowledgi g) (Signature of Notary Pub ic-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 Identification Produced Produced Commission No. C tFAY D��/ice aY mal) KAREN S. NIE �m Sion No. a ( k& N S. NIELSEN Commission k FF 11 5637 3+ += Commission#.FF 115637 +_ - _ My Commission C Aires 'rnsl �a"c My Commission E .�OFFIO`,t June 12, 2018 June 12, 2018 REVIEWS FRONT N -it VEGETATION SEATURTL ASU COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW- REVIEW DATE RECEIVED DATE COMPLETED ev. 4