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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 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: Legal Description: J F N©ur l� C�7�i� i�Q ,~�'s L� C`l irk FC V2- Lf SS N 150 F -And S F�0 Ef I -A N C3 E DF_ M ~1S �- Property Tax ID -#t:: n l--1 1- ©- Lot No. ]-A IV Site Plan Name: Bock No- M Project Name: Setbacks Front Back: Right Side: Left Side: i lid Cor liy-dak itiona workto be perrormeca unaerin+s per1rnL-uir-%- Mechanical Gas Tanis Gas Piping Electric _ Plumbing — Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ -QD appy: Shutters /Windows/Doors Generator Roof Sq. Ft. of First Floor: Utilities: Sewer _Septic Building Height: Name Address: ind KC -LOT- City: i� If State: Zip Code: Fax: AILA Phone No. (11 4LP14- E -M - E -Mail: Fill in fee simple Title Bolder on next page ( if different from the Owner listed above) Name:&&Ar) � -i' & _ d 3'fcc, sio� 1�r Company: mid E rise ap b a Address: 1 105 7arnciba Df City: Indian I4arbV&z (-f ed -h State: F! Zip Code: 3Zg37 Fax: 32-1- 777-- W3 Phone No. 772-337-,V'170 E -Mail bu:k5Sb aun State or County License: T if value of construction is 2500 or more, a RECORDED Notice of Commencement is required. 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 pasted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commenci work or recordin our Notice of Commencement. — A"& Z14 jklzow_la'zl�_ s _ Signature of Owner/ Lessee/Agent signature of Contractor/License Holder STATE OF FLMIDA } STATE OFF IDA COUNTY OF VCx�_ _ COUNTY OF The for g lnstru entwas acknowledged before me Thergo's acknowledged before me this of 20 Mby 1 o 20 LT by a o ck i ) 1 ( a erson a wI dgi i i a b`- state ..f orida j i n u b i- t e f Florida ) f I Ily _ �Ofi b ced Identification P ally roduced Identification Ty Identificatio Pr e ntif Pro d �p{j{�/ .rj/gHrl VRUVf\Gs�i71 - k F.r, Commissi a+ �x htYGpfY@IONFF244S55 Comms n� Via' BR iGETI s 4655 EXPIRES: June 25,2019 .- EXPIR #FF2019 3ondedihruNotaryPabbrUoderxrtes �Ir EXPIRES:] FudicUne 20% �`''ii' 9andedTtrruNotaryFuhlioUndunwrilers Revised 07/15/2014 a4 .sr^ 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: REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS 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 pasted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commenci work or recordin our Notice of Commencement. — A"& Z14 jklzow_la'zl�_ s _ Signature of Owner/ Lessee/Agent signature of Contractor/License Holder STATE OF FLMIDA } STATE OFF IDA COUNTY OF VCx�_ _ COUNTY OF The for g lnstru entwas acknowledged before me Thergo's acknowledged before me this of 20 Mby 1 o 20 LT by a o ck i ) 1 ( a erson a wI dgi i i a b`- state ..f orida j i n u b i- t e f Florida ) f I Ily _ �Ofi b ced Identification P ally roduced Identification Ty Identificatio Pr e ntif Pro d �p{j{�/ .rj/gHrl VRUVf\Gs�i71 - k F.r, Commissi a+ �x htYGpfY@IONFF244S55 Comms n� Via' BR iGETI s 4655 EXPIRES: June 25,2019 .- EXPIR #FF2019 3ondedihruNotaryPabbrUoderxrtes �Ir EXPIRES:] FudicUne 20% �`''ii' 9andedTtrruNotaryFuhlioUndunwrilers Revised 07/15/2014 a4 .sr^ 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: REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS Sl1Im Sf1 G1 Q w m a O O v G G) ol G N to c 1 0 Cco 00 1A CM1 0 (n! p� �� [n � V W I A B, co v Cil fD W W , O PQ w w to a i TJX I m O msn � WLn E N w S] €m i m M N m x 3 cv' N m '� s j z 4 ( ca z m ~{i vii _ [> • s E m I 70 -n m c + p rc I i I q O m ; n — h Cl o � oro m a i TJX I m O msn � WLn E N w S] €m i m M N m x e N m '� s j z 4 ( O v vii _ [> • E m I 70 -n m c p rc I i I q O m ; n — h Cl o � oro m �7 F C yy co Z7 IQ m O O y q o =0 O z cn z 'a o 'u 0 o z Q O ! € D ui JTI m cn p q� C co z z ;u z I �T o y N im a A q r N A�(DZ 0 00 ,�.'�aq m 2� 9c vy rr W rr p I7r�= �a eoirD z�'sPw aJA,m G) a 3 a � c!z m m ;mu io= D ��]o_x X �: a Z�,qo cn M Ln- cu D 95 r �^ mm cna 1 tai m 0( DN Z Oo In71 yv w C7 �¢- M �IC)0 mm K '� m � O°itn � �� � �=� 41 ��m A m NI1� G')y��.�. � n � i m 0 000 Nx i I� 0 c !I o o E" w a o o C. 0 0 Gn ul N s CD! 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