Loading...
HomeMy WebLinkAboutBuilding Permit Application s„ All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION-TO BE ACCEPTED Date: 16. 1 ri Permit Number: � a. RECEIVED FEB 15 2012 Building Permit Application PERMITTING Planning and Development Services 5t:Lucie County, FL Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential I PERMIT,APPLICATION FOR: �1��© �© PRQ QS-DIN °�ROVE�MENT 0 ATI 'N: Address: d 6 e Legal Description: e _5 re g P �I fS1 ��-.�_ � Property Tax ID#: 1,0l- dp/O - QW-t, Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: D PLED � ESS'�R'PT 0 � 0 an6E H 0 1J e V CQ S;T UCI'IO A ,) �'N Additional work to be pertormed un er t is permit-c ec 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: 00 Cost of Construction:$ 20(W Utilities: Sewer —Septic Building Height: 01N ER/L SSE: CONTR CTOR. Name -�. ©SS 'o lw 41 ame: /yl "f i ✓1 Address �C3� ✓�e� Company City: A,cCe Q State: ice✓..; °Address::.._&%O'z Zip Code: rS 2�, Fax: City: �� ��►��_-� State: Phone No. Zip Code:`3�9f1-Z _ Fax: '722-qZe-373e1 E-Mail: Phone No --S' 772 -376 -/eiS- Fill in fee simple Title Holder on next page(if different E-Mail ✓? 0n C_1711_5 r .-�4: , C-03-1 from the Owner listed above) State or County License ni Z— If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. I Jill SUpPiEMEN1'AL CONSTR CTI.ON LI,E LAW LNF®RMATOR 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. Signature of Owner essee/Contractor aL6gepJJ pr Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORA COUNTY OF � ��,c.A_e COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this�day of �^` 20J] by this lS_day of Ve E . 20_�7 by nn'kr (Name of person acknowledging) (Name of person ackno ledging) Qature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida ) Personally Known ✓ OR Produced Identification Personally Known OR Produ e Type of Identification Type of(dent&ation " KAREN S. NIELSFN Produced -Produced ,, �� `�'= Commission# FF 115637 °• - My Commission Expire aYPY`'•, LAURENMONIA-MMNNIN' °Our '`�� 2018 'v� �f' ne 12, Commission No. Igg/I *` (5i al)MYCOMMISSION1kFFt72 fo mission No: ' ' EXPIRES: BondedThruNottiryPub cUnde Pers REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.