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HomeMy WebLinkAboutBuilding Permit Application iI All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I Date: 3- 13 "�? Permit Number: Building Permit Applicatli,on Planning and Development Services Building and Code Regulation Division 2300 Virginia A venue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial t/" Res,idential I PERMIT APPLICATION FOR: PRdP 2 55 1 INRR YEMEN LaCATI g �U: Address: MAK;A-� Cir'e/e, T � I Legal Description: Property Tax ID#: �� 7- lI/ - yh l ' b o D -3 J Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: it I DETAILED D.E�SCRtPTI©N O.F W0VR9K: - t�Bltilei,-e jv�� o..J�.�-F'x�vr,�s �I- A�c� ltreui l-C� I-�'�Sf'+�►'es will need -o pi ee Ir\ Sow>e new r,y4urzs d- Vvl1 I'vew L kc 5 i. C®NSTRUCTION INF®RIVIATI,ON•: Additional work to epertormed under this permit—c ec a t at app y: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors —Mechanical —Plumbing —Sprinklers —Generator '' Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor: Yi Ii Cost of Construction: $ .zpO- Utilities: —Sewer Septic Building Height: 01NNER/LESSEE: aONTRAC+T®:R: Name eIG�er� `V�oS,o+L,.hS ,. id5 GGc, ame: 'Address: u/o.d Rri/k�. Cir sCompany �*2 ej../ee, .. ,City:. State: dress: �pdin �rtif Zip Code: 3�y�7 Fax: City: �� J iState: SOA Phone No. Zip Code:�3 q7 q '7 it Fax: E-Mail: Phone No I Fill in fee simple Title Holder on next page (if different E-Mail from the Owner listed above) State or County Licensee /.3 DO 22 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. I . S PP EMEN Al CONS�TR�U�TIQN L SEN LAIN I� FORMATIO 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 thepermit holder to build the subject structure which is in.conflict with any applicable Home Owners Association rules,bylawsorand 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 Ow r/1_6s ent Signature of ontr ct c nse Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF .S� G(,cie Co COUNTY OF 511 LUL i'z Co The for oing instrument wa acknowledged before me The forgoing instrument was acknowledged before me this IT day of K,4,Y-&1i 20JI by this jg_day of MAYL& 20_)_7 by (Name of person acknowled ing) (Name of person acknowledging) ature of Notary P blic-S to f Florida) (Signa(uL&drNotary Public-State of lorida) Personally Known Isad�deai#isat' Personally Known OR Produced Ide tification Type of Identification ;t''r'"s BEN C HOPPER Type of Identificati n Produced ' MISSION#FF166119 produced y:. C HOPPER '„�i'oFd?. EXPIRES OctobBr 6,2018 ” MY CO IS ON#FF166118 �AW) Commission No. Commission No. '.... .':�`.._ Flo aryService.com oFf, EXPIRNMober 6,2018 (407)398-0153 FloridallotaryService.com REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Te—v.7/2014