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HomeMy WebLinkAboutBuilding Permit Application i ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 7'-��I/ '7 Permit Number: I 111AWC-1 Lo I Q9 Building Permit Application RECEIVED Planning and Development Services APR f 2 2017 Building and Code Regulation Division 23001rrginia 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 Address: it 0 c5?sl 54 ®C S411 _D Iy 9- L07- 9�9 Legal Description: W 117D41!LL I.e1LC �,� ��T SSS �anc�c��inic�yr /�� 2U % S® 4,4_e,-D 12,+-rA 5N•3/Lf. 1A 60/n,4W/1 67&eNfN7.S (or 2'780- /L//8�_ Property Tax ID#: y5-11- Er10- o® 8.7 - ©O0 l Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: ORION MINOR Additional work to'TI orme un ert is permit-c ec a appy: HVAC Gas Tank ❑Gas Piping _Shutters a Windows/Doors Electric Plumbing Sprinklers a Generator Roof Total Sq. Ft of Construction: _ Sq. Ft.of First Floor: Cost of Construction:$ 35-® Utilities: Sewer E-Septic Building Height: Name LC.4 %AveName: �`ilyi `Ttf Address: 19:9-9 IJAJ ZZ r, S?. Company: ' G J'('J5LCO City: ►L1,11 o Gt-} State: Address: 556,0 /lkJ �/2Z!j!'6i/S7 7l- Zip Code: Fax: City: Eor—' ST- &Je State: o-'--<- Phone No. "7*7 'z-Z 9 8-- 0/-7 3 Zip Code: Fax: '777-3110—7/75— E-Mail: Phone No. 77Z 3 110" 74/7 / Fill in feesimple Title Holder on next page(if different E-Mail: b to i i I a ccl C from the Owner listed above) State or County License: �'C - /300 3 Y/J`— I If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. i ii mill 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: I 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 cirk,or recording our Notice of Commencement. Af _Signature of Owner/Lessee/Agent Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORgAI��� COUNTY OF COUNTY OF The for Ing instr ment was acknowledged before me The fo.,rgoing instrument wf s acknowledged before me this big May of 20 ( -by this clay of 20 Mby Q fP_l ua-- (Name of persona no edging) (Name of person ac wledging) *nature of Notary Publ' -State of Florida) ature of Notary Public-State of Florida) Personally Known qR Proms Personally Know R Produced Identification Type of Identificati :P ucer-OMMISSI6td F'r5B Type of Identific t. �1a �uce EXPIRES�cil 11,2019 °= MY COMMISSI� aosi�� 909394 Commission No. Florida ary rvke.com Commission No =�R o` ""il • RES October 112019 007)398-0r 53 i FbridalloteryService.com i Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS i