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HomeMy WebLinkAboutBuilding Permit Application DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: -Phone Zip: Phone: — I 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 your Notice of Commencement. 77, Signature of Owner/Lessee/Contractor as Agent f( rt Signature of Contractor/License Holder R STATE OF FLORIDA ;R O :g STATE OF FLORIDA =t5;6 0. COUNTY OF ad U32 Z COUNTY OF _4L Cd U52 The forgoing instwqient was acknowledged beforE njm The forgoingin§�trWent was acknowled d befor M UJ this >-UJ 0 thi!i-a day of 20/7 by th day 2ri by -;j 0X L ,it fin be U, _E for 7 by 'y; g 2e L) J-0 (Name of person-a—clnowledging) (Name of person-acknowledging) A- (ILI e LA41-r. (Signature of Vary Pub I lic-State of FloricU) (Signature of Vary Public-State of Floridg) �J Personally Known OR Produced Identification Personally Known - OR Produced Identification Type of Identification Type of identificati6n- Produced Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 4 All APPLICABLEINFOMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED f Date: Permit Number: d)"' 7 RECEIVED +l►, s Building Permit Application JAN 2 5 2017 Planning and Development Services 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: oil Address: ,¢a0 `/ Gn�/� Legal Description: r�'� 2, A lb ca gc woo cf Tct r~K (A vi K/ � I P4 2 Property Tax ID#: " ��'�'r D00 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front .30 Back: 2 65,'7 Right Side: Left Side: q, y or,en o 2 f - Ci ro 1 cCL 1 ! a tf er�GGt Cr,,t YID C u j-u+/C,S rL� C Ltd CS Additionalwork to be pertormed under this permit–check all that appy: Mechanical _Gas Tank Gas Piping _Shutters _Windows/Doors _Electric _Plumbing Sprinklers _Generator Roof Pitch dD Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ © Utilities: —Sewer _Septic Building Height: Name S t"I -Te'Alt K-5 e,,-% Name: el CA 94, . ysev, I t-G_ Address: 8TC 0 (-/ _'�o,0 '1 1�wc- Company: 4 c.401ric &,ell l te- co,c lc/._ City: F P.ler u-- 1 State: – Address: '>7 4 11 rood Zip Code: ,'� L/ r�S ,� Fax: City: r-L r, c-�-- State: F/ Phone No. Zip Code:� 41/QFax: E-Mail: Phone No %7 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.