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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �� ��• �' Permit Number: �.H, ,� .'S � ;z:. A _°^+•tve9 I .fir,^ REC I V uz MW Building Permit Application MAR 2 2 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: PR000I Q INPR01/EMBBENT L.®CATIO U. Address: 179 i4 c/Rle- ., o iof e- f� ��s<e � �yg6`1 Legal Description: Property Tax ID#: l-; ) 2, _ 2(9 0 0,N--M 0- ;?. Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: X E:PEA:I I E.�PJ DESS *R}I'PTION OF 1NO.R Re�r9a� l�� /`P•y!o va b /�, X 9 /Ylb 14i le 1i e pi2 CONSTRUCTION INFO MATIN; Additional work to be performed under this permit-check all t at.app y: Mechanical _Gas Tank Gas Piping Shutters 'Windows/Doors' Electric Plumbing _Sprinklers Generator Roof Pitch Total•Sq.,Ft_cf Construction:.. Sq. Ft.of First Floor: Cost of Construction:$ / $dd . Utilities: —Sewer —Septic Building Height: OV1/NE LE-�S1SEE: CONTRACTOR: Name ��Qd erC1, Cirt� Name: a�CS ec C Address-Ade, ��r� / �c�a��. Company: !2/a City: I/--/- A;rlee State:AZ Address: -760 <, le.-valel, �a•^�+ Zip Code: `� Y� /�� Fax: City: /0_r�7 i'ClC Stater Phone No. 77z 0-16 " to Zip Code:TVeY y Fax: E-Mail: Phone No 774- -5�Zg -11 '50 Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License C Sc* ©5-Z If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SU'PP'L.E�11/IENTAL C®NSTRUCTt®'IV LICE=N LAW INF®R'I�/IA�TION 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 commencin work gr recording our Notice of Commencement. T f � I Signat a of Owner/Lessee/Contractor as Agent f P.O. ,9-71 ; Signatur f Contractor/License Holder Oz STATE OF FLORID - °;: STATE OF FLORIDA= COUNTY OF COUNTY OF The forgoing instrument was acknowledged efor �l 00� The forgoing instrument was acknowledgedbefore this day of le e ,20J,by this day of /h,0 1Q C -20-L-C Uy :xQ v ypJAW :P = 2 370 co W (N a of person acknowledging) "N am of person acknowledgingT m Co 011/h/WL N Signature of ary Public-State of Florida) (Sign ure of Notar ub ic-State o Florida) Person own OR Produced Identification Person own OR Produced Identification Type of Identifi do n �� Type of Identi 'ca on Produced „J`'L Produced Commission o. (Seal) Commissiozi (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.