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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: z • Permit Number: © •O C0 1 ED 6unuing rermii i►ppimation MAR 3 1 201 Planning and Development Services Building and Code Regulation Division PERMITTING- 2300 ERMITTiNC2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie County, FL Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential FERMI I APPLICA I ION FOR: To Select from dropbox, click arrow at the end of line f. F' UP SED,IMPROVLMENI LU(.AI'IUN Address: Asa Legal Description:R„erq_a31�'.3-1P tyti�� Property Tax ID#: 3y\�z,- 53 o- oe,-i, oop 1 Lot No. \ Site Plan Name: Block No. 3c� Project Name: Setbacks Front Back: Right Side: Left Side: E l AILtU UESC,'RiP-I ION OF WORK 4 , 4- (f If r5 -39. `' 6 r- w4t-M qc1\1yi. piP_k< t C' s•,-L kill wtdt- X 30, 1( OtCH TOTAL CONSTRUCTION:INFORMATION Additional l work to 'e er orme under this permit-check h al appy: HVAC rl Gas Tank Gas Piping _Shutters a Windows/Doors Electric 0 Plumbing []Sprinklers []Generator Roof Roof pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction: $ 5-67- Utilities:[:]Sewer _Septic Building Height: 'OWNER/I_ESSE.E: . CONTRACTOR: NameTUYGJ. CA-r44, Name:V—tc_ Address: City:. State: Qv Address: It oSn -,to 5 Zip Code: Pic,,-:,-�a Fax: City:P„r_�- State: rL Phone No. -,ms s --kc) ca:)-1 Trp Code: -5,A9 t 3 Fax: E-Mail: (2,oy. Qcs v, Phone No. D Fill in fee simple Title Holder on next page( If different E-Mail: ., from the Owner listed above) State or County License: C t�C_ 0_S' a o L R If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. U,'.'LtM tN' AL GUNW NLLNNFV 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 prop rty.A Notice of Commencement must be record nd posted on the jobsite before the first inspection. you intend to obtain financing, consult with len er or an attorney before commencing work or r c r ing your Notice of Commencement. I � k (�. "_� �A � s Signature of Own essee/ ntractor as Agent for Owner Signature of Contract r/License Holder STATE OF FLORIDA STATE OF FLORID COUNTY OF S�-.i_ , -e- COUNTY OF s-�_ :a The for �oing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 3o day of_>�ti.`_ 20 v-, by this 3o-qday of M���h ,20 ,-1_by (Name of person acknowledging) (Name of person acknowledging) (Sigr@tuf Notary Public-State of Florida) (Si atu f Notary Public-State of Florida) Personally Known ✓ OR Produced Identification Personally Known -",/ OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No. 5 c o fission No.(-'(: KELLY JO MAH N KELLY JO MAHAN .= '�:� •..�:�` �... :oma: Revised 07/15/2014 EXPIRES February 5,2019 +,� -- EXPIRES February 5,2019 or h,,,•• (4oz)39a-0153 FloridallotaryServlce.com (4o7)3w-oi53 FloridallotaryService.com REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INIIALS T