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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �t� Date: l.' ��' ��9 Permit Number: O 0 o F . SEP 13 R NNW Building Permit Application PERNIITTIi,,!G Planning and Development Services St. Lucie Coifnty, FL Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 / Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential v PERMIT APPLICATION FOR: PR PO •.Onnnr�rv��'1u--• a-iwr. aedM�s.,riuud`r.xt�,>c,uix .r.LN.O.a:an nCs.y�A IY*Ta IdrODET _7u7 .. P:•.t 2 r Ern i. Address: ' S l �� It, l V . i Legal Description: Property Tax ID#: r ®©® " Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: D'ET�A°I,LEtD DESCRIPTION OF V1/ORK. &T- 1 T 36 `L P-W - oo r S MIT, A� � P €� CONST r.UC�TlO'N INFORMATIOUR , x Additionalpi workto a per orme 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:$ NZ Utilities: _Sewer _Septic Building Height: OUI/NE'R/LESS -E,: CONTRACT®•R• Name Name::_ :, M Vt d: t.i� (;c,v� ompany: Address: oC I Stater Address::- Zip.Code: Fax:' / City: State:, Phone-No: , ��� 2-19 Zip Code: Fax: E-Mail: Phone NqL. 3 Fill in fee simple Title Holder on next page ( if different E-Mail L from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. S�UPPLE�IUI =NTA�L CO'N�STR�U�CTION LIEN LAW INF'ORMATIO'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 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 atto before commencingwork cordi ur Notice of Commencement. Signature of Owner/Le see tractor as Agent for Owner Sig n ractor/ i ns older STATE OF FLORIDA + STATE OF FLORIDA 4J " ' COUNTY OF C 4G' y , COUNTY OF LUC' 16 , The fo going instru ent s acknowledged before me The fo oing instru ent s acknowledged before me this day of 20]�by this day of 20—JU by (Name of pe on acknowledging (Name of pe�r�acknowledging) (Signa ure of Notary Public-State of Florida) (Signature of otary Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification V/ Type of Identifi ion Type of Identific tion Produced KAREN S. NIELSEN Produced .�•�' Commission# FF 115637 Commission No. z My q_kmip Commission No. //�(D ""' sion Expires 4,...,,,;�� %',;;,;��t,;,•° June 12. 2018 =• •�; co, si S NIELSEN sion M' mis #FF 7 1 sion Expires REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA une VE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW RE DATE RECEIVED DATE COMPLETED ev.