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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: .l S s �EE, .' E t � o► MAY 10 20% Building Permit Application PEWMITrl'G Planning and Development Services St. Lucie County, FL Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 1 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential t� PERMIT APPLICATION FOR: 1 PROPOSE® INRR �/EMEN ' LO"CATI;;ON; Address: r Legal Description: Zake Lucio Z-54a eS Alo 017e, ZOTo7ej�r - P700 Property Tax ID#: qy Z 14 a©00 l Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETfLED 13ESRIPTI®N C1F WORK: W G'G board dh hchis u " eef J1lq/j Cb DF, Ui©IEyV-uW M S-JlLoD-�,� C®NSTR'l1CTI0N I'N'F®RMATI©N: `� Additional work to be pertormed un er t is permit-c ec a tat appy: _//Mechanical Gas Tank /Gas Piping Shutters 2/Windows/Doors y Electric Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: Sq. Sq. Ft.of First Floor: Cost of Construction:$ I�/�/)�Q f DU Utilities: _Sewer _Septic Building Height: QUU�NtER/LESSEE: _.CONTRACTO:R: Name U CS Name: Address: Y.? 7Y S CIP dPihc, r✓�l rC Company: City: )20r1J Q- State-A/ Address: Zip Code:.�L/� l•'-?. Fax: City: State: Phone No. Zip Code: Fax: E-Mail: 6 r arqe- D,,:_:2_ r JM ol COM6015 �t Phone No Fill in fee simple itle Ho er 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 C�NSTRU:CTLQN L�. N LAW I': FORMATION: 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. Signature o caner/Lessee/ ntractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORID* STATE OF FLORIDA COUNTY I COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this J day of�yV1 �1 20110 by this day of 20_ by Yqu li (Name of person acknowle ing) (Name of person acknowledging) Q "/,, , Ik (Signature of ota ublic-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification e"" Personally Known OR Produced Identification Type of Identification Type of Identification Producedmoo. d KAREN S. NIE SEN Commission## FF 1 Commission No. ='f S _I) Q6�1'mi ion No. (Seal) ��qr Porr My Commission Expires June 12; 2018 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.