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HomeMy WebLinkAboutBuilding Permit Application A7 0 . �. ALL APPLICABLE INFO ST BE COMPLETED FOR APPLICATION TO BE ACCEPTERt• Lucie COUf4 Date: PermitNmksi De`1rt1ent Date: I 3 I i1 - prov d By- Building -Building PerriUAp �- SABLE ATTAINABLE Planning and Development Services WORKFORCE DOUSING 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: To Select from dropbox, click arrow at the end of line 1?ROPQSED t.MRR�JVEMENT LC)CATIUM ,_ Address: O Legal Description: Lot No. Property Tax ID#: CLQ `� 5 "— Block No. Site Plan Name: _ Project Name: Setbacks Front Back: Right Side: Left Side: 7777777-7=777777-7 77777777777777 DETAILEp=DESGRIPI'ION Q WORK lta d b k.�,o 2 1q C co,%, c Q �7 U ff(%v cb 0 ©per ice . `) CONSTRU.CTIQN lNfOl�IUTATION;.r z . itiona wor to e e orme un er t is permit—c ec aIrShutyte: rs HVAC 1.Gas Tank ❑Gas Piping �windowsf Doors 11 Electric Q Plumbing Sprinklers Generator Roof C� Roof pitch Total Sq.Ft of Construction: S Ft.of First Floor: �y v Cost of Construction:$. Utilities: Sewer Septic Building Height: OWN£R/L£SSE� _ �co�u-fRAcroR 777t Name Name: lA f �Zr2 Address: Company: n - ` State:�L Address: City: 2 _ Fax: City: ' r— state. � Zip C de: 2 Phone No.s, —Z� %� 2 Zip Code: Fax: - E-Mail: Phone No. f n2z) 11-69216 � a Fill in fee simple Title Holder on next page(if different E-Mail: `\� ��C Z from the Owner listed above) State or County License: ff- ( `? if value of construction is$2500 or more.a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: T Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: Y Not Applicable BONDING COMPANY: , Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: 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 wvice 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. �11 51A4 s signatqU €trwlfer/tessife) as Agent for Owner SignatLWorContractor)lice r&v"gcle—r STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The far ping instrum nt was acknowledged before me The forgoing instrument was acknowledged before me y ei.7 this qf`da�Of e,�yuc�, 20 Llby this-1 , Uay of fe-lrvp tN � 20 by (Name of person acknowledging) (Name of person acknowledging) (Signature of'Notary Public-State of Florida) (Signature of Notary Public-State of Florida Personally Known `�OR Produced identification Personally Known `-�'OR Produced Identification Type of Identification duced Type of Identification MA DE LA LUZ VELASCO MA DEI t&6q Z VELASCO Commission No. My COMMIT G13050399 Commission No. m Y COMMISSION#GG050309 EXPIRES November 23,2020 "28 EXPIRES Novembet24_M_.M_ Revised 07/1512 14 REVIEWS FRONT ZONING' SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE ;,g ed 014 COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS