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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: L�'a.'� ' �� Permit Number: r.r Building Permit Application APR; 5 2097 Planning and Development Services Building and Code Regulation Division PEF1 0'17TliN?G 2300 Virginia Avenue,Fort Pierce FL 34982 ct' Lug�2 county. FL Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED JMPROVEMENT LOCATION: Address: I QIP J • 0 lA aA Legal Description: cc am 77yieU' cn e 6 to T %3 o Property Tax ID#: 7 J d .11>)'UrM" lro� �� Lox No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION WORK: '. 6-_. 30 6, -c",u Z &UA TR- 14 SA-T£- C flR ti 6r�7 © T [c::6::NSTRUCTION.INFORMATION: Additionalworkto e .nertormed under this permit=check a appy: HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors Electric ElPlumbing Sprinklers Generator Roof .Roof pitch Total Sq. Ft of Construction: SFt. of First Floor: Cost of Construction:$ /, Zoo. 00 Utilities:Sewer[]Septic Building Height: st z CiWNER/LESSE'E: ° CONTRACTOR:- Name rOC Name: Pii !,, .JC: � , Address:f - Company: ff'(1 >t ?a,, b b"-14 Gema City. State:iff_ Address: .� �7�•1,. �4Z Zip Code: tt f �/n FCa�x: City:W_ O r/-�y) State: Phone No. ✓fk off' O b Zip Code: L b . Fax: E-Mail: Phone No 5 J > Fill in fee simple Title Holder on next page(if different E-Mail: J U j 6 ` ,t1_ �> c19W from the Owner listed above) State or County License: (3 C Wt (l. �i� If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SU"PPLEIVIENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _NotlApplicable 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 thepermit 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 worh or r r in your Notice of Commencement. s Signature dVown r/L ssee/Co ctor as Agent for Owner 'gnature of Contractor/License Holder STATE OF FLORIDA a STATE OF FLORIDA COUNTY OFCOUNTY OF The forgping instr ment was acknowledged before me The forgoing instr ment was acknowledged efore me this day of 20 11 by this day of 1 20 by L)��j JV&P 6WIWaJt­ (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public-State of Florida) (Signature of Nota70R lic-State of Florida Y ) Personall Known OR Produce Identification V/ Personally Known Produced Identification Type of Identification Produced (' L_ Type of Identification Produced �} KiMSEALY L So &WM GE C 1`JZ10 , KAREN S. b9CommissionNo. ,, .. n o. R�. : �S��pMMISSION M FF2 2 Commission## F 11 EXPIRES.iww 2S,2CON 12, My Commis ion Expires I 11111111" Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS