Loading...
HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED f _ Date: Permit Number: (0 ,- RA ECMYk Building Permit Application MAY 12 20116 Planning and DevelopmentServices 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: To Select from dropbox, click arrow at the end of line PROPOS'_ED IMPROVEMENT LOCATION r... Address: c�`� L) /60d wl P)a, 9 VC-15 Legal Description: Cbbwco �0-j-, 0b6`1 34 3q fltl Wr-,,€s c�ct�aD GB 7 c) k3oo4h 8cx.m , r. �7A P,Pfc-e , FL 3�?Q!5 PropertyTax ID#: Lot No. Site Plan Name: Block No. Project Name: oa+e a( hc�(-Ci Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTLON OF WORK (1 s-bx u Cf-no �"te �� CONSTRUCTION 3 INFORMATION' Additional work to be nerformed under this permit-check all that appy: HVAC Gas Tank E]Gas Piping _Shutters Q Windows/Doors Electric ❑ Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: d 50 S . Ft. of First Floor: Cost of Construction:$ l�©� D© Utilities:Sewer Septic Building Height: 01N.NER/LESSEE CONTRAC ,OR Name ( Qr oa�2. Name: r i Q Address: 306e i7dAron oae_.,) , j Company: rp-a 1 City: iJ orqt\ bio, State:(IA) Address: _ ISIS Zip Code:�(� to q Fax: City: vi er Stater Phone No. Ja5- 4 502� Zip Code: J qg g,a Fax: 77,2-Ll(a t(- (o 000 E-Mail: Phone No. -7 73�- U to y-W'06 Fill in fee simple Title Holder on next page(if different E-Mail:eri it.1'4rP_a l(6(rz_Q I-Do drl.o co:" from the Owner listed above) State bd County License: 02C 13 J(a !7 7 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. W 5; fti 151 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, consul with lender or an attorney fore commencirIg work or record' our Noti a Commencement. Signature of Owner/Agent/Lessee Signature of Contractor/License Holder STATE OF FLORIDA ( STATE OF FLORIDA COUNTY OF ,� � . \ U G1 COUNTY OF r 1 et The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this_(Qn day of Mrk 20� by this&�q2 day of 201_�, by ( e of person acknowledging) (Name of person acknowledging) c� (Sig atur of Notary PPuubl -State of Florida) (S natu of Notar7OR c-State of Florida) Personally Known V OR Produced Identification Personally Known Produced Identification Type of Identification Produced Type of Identification Produced °`:R•P�B`% NNIFEROBERT Commission No. ';'Ry P&, (Seal) Commission No. vMMISSION#EE 215904 JENNIFER OBERT EXPIRES;November 12,2016 'P *IT I COMMISSION#EE 215904 N�'TFOF FL&e•\O Bonded Thru Bud e �'J.November 12,2um REVIEWS FRONT ��Z61MNG Bonded hSUdWA I' Ft PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.7/2014