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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Dateu"O_25�_0Permit Number: IlQ(a� �C® - JUN 2 F 9016 _ Building Permit Application PERW,1IT i,,\],z 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: I -z �(iyr a z••# _p�r�€n: "x ' sx t^w PIIOS,E� � I I LCtC�tT)fN h �.y gZ4 it6y dlhs '. k in ; .aa:. :. r d aw Iarc. �7sa',o Address: C L) Legal Description: Jam- f �® Property Tax ID#: Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: 64"z k;iu •s.t` a ria spa a d o''y'• '#� m,, a Y„y,a. tt t'„l :'� s •: .N'�`v - LDDE ', tPTtC3N: 1NORI Y a ','t'i'v "rh-,r^, ': .rP,Ari w...'�"fir.-, Yk 'e< W"M 7,;r"'urn ra�. ~v?h "..SS `*F�t,rb d'+z,q a „`r;. a ": 4`' n j..-:.,+�y 'a.,S,.i�4g iRa i, h r, �'z•„: :nt±` ,z?rAyh* 4ITc I.,O.N>:e;-'•s>�x rr" .a j'Jy' {fd: © rtapeormeunertma that apply:itois . Add _Mechanical _Gas Tank —Gas Piping L11'hutters —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: .r ra;- re rry - y " • d"T&_ OR(, ".4 `s. - � y"ys ql y O t" ;;GT3-z lb."h.:t#,§ �„y ,.r.. •m. ,aa�,.rupy ,xJFW k; 9«P.PC. .�'�s. �� '�a a'"�^h v,l9 ��n%,w%�-....�fR a��.�„-:'.t�,_ +�;�` �, iF`:�lg��<.. .-..,5.... :§, R+.-t ..:r.-•X��.a Name *!9Le_� Nam Address: 13-z S'l= ��^seey:-�� �LUh Company: City: ffi"4 9G` C_ 0— State:(-- I Address: Zip Code:31863 Fax: City: State: Phone No. `772— 3z3 '7 1 Zip Code: E-Mail: 16y S(ewe et-D G� k e, sn' Phone No Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or Coun License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. St'.. E'{VIE�T' riL G+DfVCTI®NE~1N Llt1l� 1R�i1/IATIN, r . 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 ICOMPANY: 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 recooing your Notice of Commencement. ?ignat of ner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA. STATE OF FLORIDA COUNTY OF Lu c�,(e_ COUNTY OF The f instru nt was acknowledg efore me The forgoing instrument was acknowledged before me this ay of 20�by this day of 20_ by (Name of person a knowledgin ) (Name of person acknowledging) (Signature of Notary P t ic-State of Florida) ignature of Notary Public-State of Florida) Personally Known OR Produced IdentificationPersonally Known OR Produced Identification Type of Identif'i'' Type of Identification '• NGELA M HUFF Produced ' PR"_°�a Produced U iC-State of Florida :• Commission FF234730 Commission'No. (Seal) Commission Nc�.`N '� m.Expir s�Cfa 27,2019 „ Bonded through National Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 4