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HomeMy WebLinkAboutBuilding Permit Application I All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �1 Date: T ` i-�--1Permit Number: RECEI�;�D AP,'; 0 .3 7 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: PROP®4'ED INPROVUEMcyfNT L©`CATIO Address: J�ZJ b Cvl in4+p 1)r- R PiG-Ct, EL• J yG Legal Description: 717866n .yGr L(nky 0(o 6Lk ao L-oh I(, I`l Property Tax ID#: .3y©.,- -bog - OWT - 6004 Lot No. i(v I I Site Plan Name: Block No. o?b Project Name: hid'►On Setbacks Front Back: Right Side: Left Side: DET L�D. D�Ei CRS PT�[� ® ORK CONTRC ION S ,UINFORMATION: Additional wor to be performed under this permit-check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors _Electric _Plumbing _Sprinklers _Generator TRoof �itth Total Sq. Ft of Construction: 3 7160 Sq. Ft.of First Floor: ' 3700 Cost,of Construction:$ ,�,�, ��✓��� Utilities: —Sewer _Septic Building Height: OW ER/'LESS CO A OR: Name�Q?)olct 1:11-1`1151 ` (GLH I li'_r Name G F�71) Address 5 $Q �c,�m�-I-�o fir. Company : �v 1Fran�e.,rov�inq Cityl _ :: � t State:°�V -Address:.'f,�,o.-.`•.- �, %&I Zip Code`: gp = Fax: City: State: FL- Phone No. ' 'la -Sa$-3.5T(o Zip Code: .341 $S Fax: ri u-33& E-Mail: Phone No � 33&,3 8'8'0 Fill in fee simple Title Holder on next page (if different E-Mail Ste-%K. Frpn ✓G rA+. ne+ from the Owner listed above) State or County License U-c- t 3a- b9ao If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. VS MEMO, RO R ION11 IEN W I FOR A I© 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 comme w-bxk or r in your Notice of Commencement Sig tur o 0 ne Less, . or as Age for Owner Uof r HolrS TE DA STATORIDA , CO OF MA94ir1 COUNTY OF MAaNr, The for �o�ing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 1q=day of YY),AAXA4 , 20 11 by this `day of MART A ,20_0 by -61V_C_ (Name of person acknowledging) (Name of person acknowledging) (Si nature of Notary P7OR Produced Identification Y-State of Florida) (Signature of Notary Pu lic-State of Florida Personally Known Personal) Known OR Produced Identification Type of Identification T e of d tification Produced � •ukF+ Notary Public St to o�FforiGa a e Carrnela Frant ntoni r � rotary Public State of I da Commission No. 115-10 3 My Commission 1€aR39fassio No. I �' (117S_ W3 !OI}� ry or n expires 05129/2 20 Carmela Fraosm/ntantor I My Commission FF 9T 7 ''� ex Ives REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. /2014