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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q41 Date: 1l• Ili •?ID it Permit Number: ' 1 -- _ Building Permit Application NOV I Planning and Development Services PERMITTING Building and Code Regulation Division SL Lucie County, FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial. Residential PERMIT APPLICATION FOR: •t�'- re -e ' r�q x PRPOS'EDINPROUEMNTLOCATIN zar � _t .. " Address: �©� IO . .�.,_ �,.t., �, �. Legal Description: Gly�"Jt� 14 Property Tax ID#:�a3© l C05 (DO19 0003 Lot No. Site Plan Name: 1]�-�, S,p �i Block No. Project Name: IVU4lJl-e Setbacks Front )0 Back: Right Side: !O Left Side: /O DAFLEDDESCRIPT1®N ®F UU,ORK ,r � , � ,'�_�_` '. .�. "�"` 1 .....'fix.,. 501. AL i Additional work to be pertormed under this permit-check all that appy: il _Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof i Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ ty0 Utilities: —Sewer _Septic Building Height: r - OWN;ER/LESSEE: a CONTRA Name V-b4 kN P e Name:. Address: ll(oq( forma. G� Company: City: P�)_ State: Address: Zip Code:=�TQ •Fea�x: City: State: Phone No. -772 �Pli �-O7 Zip Code: Fax: E-Mail: )0! ,il 11P,�i C� �, VGLGt�l (Ol Phone No Fill in fee simple Title Holder 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. StJPPLEII/IENT ►L CONSTR GTf.ON L AN MWA I - FORI\/[�►TI®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 attorney before commencing work or recording our Notice of Commencement. �o L Signatureo O ner/Lessee/Contractor gent for Owner Signature of Contractor/License Holder STATE OF FLORIDA . 1 U c," .STATE OF FLORIDA COUNTY OF L� �i CCOUNTY OF The forgoing instrum nt was acknowledged before me The forgoing instrument was acknowledged before me this 11a day of 20J.0 by this day of 20_ by szkl ( me of person acknow edgi ) (Name of person acknowledging) I a-L', (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification V1 Personally Known OR Produced Identification Type of Identification Type of Identification Produced id KAREN S. NIE SEN -+�a Commission# FF 1 Commission No. _ 8, •`� -I) ��rmi ion No. (Seal) My Commission Expires � ;;0 ��'�` June 12, 2018 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.