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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: GY ' CSL '" � Permit Number: ©C� ^ 6 RECERVED M Nam= _ Building Permit Application FEB 2 4 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: PROP®SED fNP OUEMfNT LOCATION: Address: (o';-1 23ILI 5- Legal Description: t,ay.Y wC0oJ) Priv_ Oyl1* 9- [4 t7 I-n+ ? CiM40 1.3Z02N Property Tax ID#: 1,301 6 10 00 Q -7 000 Lot No. 9 7 Site Plan Name: Block No. S Project Name: Setbacks Front Back: Right Side: Left Side: D JLED DL�SC �1P 10'N O WORK: CD STR+UCTION INFORsMAT10'N. Additional wor to be pertormed under this permit-check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors _Electric _Plumbing _Sprinklers _Generator b,_Hoof Y l,2 Pitch Total Sq. Ft of Construction:-_ ,S�lp Sq. Ft. of First Floor: o � Cost of Construction:$ `7 ci DTAUtilities: —Sewer -Septic Building Height: OWNER/LE-SASE : CONTRALTO''R: Name' Pa ril0d�r ��u 1(i���� Name::: :, aiJct llP_�. is Address: Ce, l'l Ow r �' Qr Company.:-,'))Y1 6P` City: ^r Tr-4'y State: Address: .3S�SD cD� ��l��,o`k7ee Zip Code: Fax: City: FT A (4 State: Phone No. Zip Code: 3 V!Z`Z:2 Fax: E-Mail: Phone No `7 7, —J0 J ff D Fill in fee simple Title Holder on next page (if different E-Mail from the Owner listed above) State or County License (_'C0__ l Z 7,212 V If value of construction is 2500 or more,a RECORDED Notice of Commencement is required: USER 'PLIE]MLAW INFOR'MATION� 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. 'A:�/ Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORID STATE OF FLORIDA COUNTY OF S�, l tie �_ COUNTY OF St The for oing instrument was acknowledged before me The forging instrum�rent was acknowledged before me this��( day of2)Q ,20 by thisday of_PC.b ,20_0by (Name of person acknowledging) (Name of person acknowledging) s (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known__t---OR Produced Identification Personally Known -----OR Produced Identification Type of Identification Type of Identification Produced Produced r" •• SOLOMON LEE SOLOMON LEE P MY COMh41SSI0N#FF 912389 `" MY COMh ISSION#FF 912369 EXPI 1pvember 15,2019 Commission No. _�. Commission No. = '.. EXPIRES81e,4mbpr15,2019 f,,,.• Bonded Thru Notary Public Underwriters q Ct, Bonded Thru Notary Public Underwriters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.