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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Dater ` 11 Permit Number: a R E C U'. J SPR p 4 2017 • r 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: SPRPC�3SED INPROVEM�EN�,.LOCA#TIQN � aMORE. . " 47, .� XI .�.bi� .'�E4 �` .f Address: © ��, L q1 l Legal Description: - ��d/2eWOpdkh /t?-A1C 133dA Property Tax ID#: Lot No. Iq-11 Site Plan Name: Z� ��L.GCP_ Block No. 123 Project Name: JaWK Setbacks Front Back: Right Side: Left Side: - s "�;„�ti ?^{� �a�� ��s �� ��. ,�;a. r. ": .M�.,a• � ,�}E� � , ��'�- �.,<w:' ����` ��� -s�, �[raw�r Additional work to be performed under this permit-check all that apply:µ _Mechanical Gas Tank _Gas Piping _Shutters� - _Windows/.Doors Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: - Sq. Ft. of First Floor: Cost of Construction: $ 5_00 Utilities: —Sewer —Septic Building Height: 01NNE1%LE�SS'EE . CONTRAOR 4 r Name W 1 C; r _� . .. Name. _.. .v 1 r Address: .�} � :•:.,. •fU•, Company w�" -2 �►"���2i S � c City: EA , L(Urc,e S ate: FC-- Address: g2 L9 G' � 1A -�-1 A---,L-e Zip Code: �3 1L c(S_/ Fax: City: State (- Phone No. '�"�02 `-a2 �a -�2 ®� Zip Code:'J:2 Z 6 Fax: Al,s4 rr E-Mail: Phone No Q 112— 6 3 3 -o Q 6 0 Fill in fee simple Title Holder on next page if different E-Mail �� � L1, �I/!C e// from the Owner listed above) State or County License C 6- C1 SU S-5-3�f If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPF'LEMIENT�AL CONSTdU'CTI:ON L SEN.LAW I�N'F®�RM�►TIQN: u DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPA _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: 7Z Address: City: city: Zip: Phone: Zip: Phone: OWNER/CONTRXi�nstallatiion AFFIDVIT: plication is hereby made to obtain a permit to do the work and installation as indicated. I certify that no worllation ha commenced prior to the issuance of a permit. St. Lucie County mares ation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict wp- able Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please coour Home Owners Association and review your deed for any restrictions which may apply. In consideration of tg of this requested permit, I do hereby agree that I will, in all respects, perform the work in accordance with ted 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 wit under or a t before commenci -work or recording our Notice of Commencement. 2 Signature of Own&/Lessee/Contractor as Agent for Owner Signal; re on o er STATE OF FLORIDA STATE OF� COUNTY OFO�I�t DA COUNTY OF '�k. Ly c'� The forgoing instr ment was acknowledge before me The forgoing instru ent was acknowledg before me this ` day of 20 by thisday of by 'C " w� � Se�dw•J (Name of pe'tson acknowledging) (Name of person acknowledging) (Signature of Notary Pub' -State of Florida ) (Signature of Notary P lic-State of Florida) Personally Known OR Produced Identification Personally Known I Produced Identification Type of Identification Type of Identifica „�;,�••., DEANNA MARIE GNENS Produced �.. Produced DEANNAM_AR!E GN1rNS :�; N#GG 022023 .••p•P r4r, �.J o. EXPIRES:Dec, I r Commission No. `rON#GG02.2G23 R T1�¢+2020 a Commission No. _4 ThruNotary by I ` � 0r,'Sj Jcetnb&16r 2020 I., enwtem :�; :a= J oP•' Bonded ThN Notary Public Underw:aerc '•FOF FL.• --- REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.