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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: \\31 \� Permit Number: ��l �a-0 x _ a ro riga 3? k y �� - RECEIV`D FEB 13 2097 Building Permit Application 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 !1 PERMIT APPLICATION FOR: p ea P I SED IIN'PR®UEM:ENT L®CATI'ON: Address: } \ a } S � c Legal Description: 1 ©1r1 Property Tax ID#: S ` O ZS I' 000 ` 2- Lot No.-2 Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DE�SCR�IPTION OF WORK: newt k e V" SYna v� �0 ST aUCTION N�FOR ATION: Additional work to be pertormed under this permit–check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: d Cost of Construction:$ 0 Utilities: —Sewer —Septic Building Height: OWNER/LEMSW-@ NO",NS C OR: Name t1Y1 Name: Address: V10 S Tvt ckA b Lt `v t `( Company:.. City: c`� �`L v C� State: Address: Zip Code: 5 L Fax: City: State: Phone No. 1 G S 2- 9 6 0 Zip Code: Fax: E-Mail: Syvn t1©1Me_� I!� P Smckl ©Lom 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. SyIJPPLEM�ENi"AL CONSTRUCTION LIEN LAU1/ IN�F®R=MA1"1®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 toldo 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 c,ovenants'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 recqTding your Notice of Commencement. a/WJO r,e'011 Sig re of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA j STATE OF FLORIDA COUNTY OF S -Y . Gy COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this \''3 day of 20f by this day of ,20_ by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Pubk-State of Florida ) (Signature of Notary Public-State of Florida ) Personally Known OR Produced IdPersonally Known OR Produced Identification Type of I.dentifi tion 0"Wa NA oRIEGNENS Type of Identification Produce - •'�:"� COMMISSION#GG 022023 produced Produced '•*= EXPIRES:December 16,2020 1� ` po Nolyrypu611cUndernnilers Commission No. (Seal) Commission No. GGA •t�.•• B REVIEWS FRONT. ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 7/2014