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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: la��(� Permit Number: ItGUO RECEIti'TD MAR 2 9 2017 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 PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line v q PRO.PdsEt IMPROV;EMEN7 LO`CAPO- Address: '�(o cF /(7s Q!'C-e Legal Description: Property Tax ID#: / 3 0( - GOl - © 13ar 06D 4 Lot No. 3 Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left'Side: DETAILED''DES"CRIPTION OF WORK f Ak- CIAA.-St 0,5 L.;Vc' /i�4- I JJe /Y de eet- 7-1- t6-Cd blf ` A C Tom CONSTRUCQRMATION y x Additional work to be ertormed un er t is permit—check a appy: DHVAC Gas Tank ❑Gas Piping _Shutters a Windows/Doors 11Electric ❑ Plumbing Sprinklers ❑Generator ❑ Roof Total Sq. Ft of Construction: SFt.of First Floor: Cost of Construction:$ Utilities: _Sewer E]Septic Building Height: 01NN ER/LESSEE CONTRACTOR:' . . Name 92- n sgee-r( Name: noJtpk CAA- - Address: rdd o 9/f0 PCompany: G'L 1kA¢1'-1 If 141 City:�� a eALL State: Address: L It 3 I) Zip Code: 311 ( Fax: City: %l' J u-t t State: ��- Phone No. Zip Code: 915 92 Fax: 729. SIG �-i90 E-Mail: Phone No. 2213 70 - q&7Y Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or County License: eAG f e/,-17 S If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRU`CTIO LIEN LAW INFORMATION:s 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: 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 Comm enceme t. C S' ature of Owner/Agent/Lessee ig aturre�of Contractor/License Holder TATE OF FLORIDA STATE OF FLORIDA COUNTY OF S*. Ly e COUNTY OF 'Sk. �►uc:�'� The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of 'M w IC 20 VA by this V%day of 1SN 4,(' .20 by 'Sash Ca�c �' S cs� o1n Cd►,r,r (Name of person acknowledging) (Name of person acknowledging) w • (Signature of Notary Publi&State of Florida) (S nature of Notary P lic-State of Florida) NpN��EGN p22 23 Personally Known OR %.IdentS�eKoG 2 2(Per nally KnownType of Identification Produced M ttEs: -1Cund `s f Identificati ;"�d nrENs =m• eF g0nd9d1hrJ ° _�; MY COMMISSION#GG 022023 IRES:D Lab�►16,2020 Commission No. �5Ll '' ,� ;�° Commission No. ,, ThruN°tayPu t u.2020ers Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS