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HomeMy WebLinkAboutBuilding Permit Application f All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1 -kn I1'1 Permit Number: RECEIV7_1 APR 272917 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 l� PERMIT APPLICATION FOR: PWE00 @"WTI!NPROUEMENT Lt7CATION, Address: 5-130 Legal Description:_�_ _ .3 S - 2or Sus �lL( �� t.➢ rA� /u �� Sr. 1,'q Le-55 l A_,,o Property Tax ID#: 23o8 3 Z-� &) l O o©o tea Lot No. Site Plan Name: Cr»C. Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED D@501RIP.ATI � F W0 ' K: ��FILI -62jCC.�f� /V SIL✓(.4J��'L�� �Cv@5TR,UCTION I IN'FORMATI'ON: Additional work to be pertormed under this permit-check a tat appy: _Mechanical 'Gas•°Tank.1 _Gas Piping Shutters.'*' _Windows/Doors Electric Plumbing _Sprinklers _Generator X Roof Total Sq. Ft of Construction:, - S? ._ . Sq. Ft.of First Floor: Cost of Construction:$ py, Utilities: —Sewer _Septic Building Height: OWNER/LE�S`�SEE C(JNI'R C�*TOR: Name6�.1Z L6 t S 6444 Name,'^ Address: �L`�O C��.u:��Cz�'�C�tj.:'.'..:`-' Company:- Al : City: State: dti Address:.. A ruv, AVt Zip Code: 3LCCI4S�- Fax: City: F�CQt�E� State: Phone No. T72, z[to - r�? ?u 3 Zip Code: 341TO Fax: w?, It&I -&(if7" E-Mail: Phone No 5772- 21(,2—&4- Fill in fee simple Title Holder on next page (if different E-Mail /�c��f6tflsiAe.tw P�a�cv�,. �/r ��rl�., from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. �UiPP''LEM —N SAL CANS Rl1CTIDN LIiEaN LAW IN�F®RMAI"ION: 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 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 le or an attorney before commencin -w r o orcliflg your Notice of Commencement. Sig ature of wrier _ essee/Agent Signature of Contras or (cense STATE OF FLORIDA STATE OF FLO �A 5 � COUNTY OF V .Ly.0% COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this Z111. day of "C I0 20_VJ by this day of Q Q C>1 20n by La,sA. y 4v (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Pub c-State of Florida ) (Signature of Notary Pub c-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Ident'fication � �,�.,,;,Type of Identificati ............ --- Produced \. Produced p hIARIEGIVENIS, 'a 4� p�erpEANNA MAf21c GIVENS ION#GG 022023 I� ' = MY COMPdISSION#GG 022023 PIRES:December 16,2020 Commission No. Q� E A�:December16.2020 'Commission No. edThE-3,D,�ee,,,�,,,,,'`` a gw�crlaUndev✓ri'ars Bonded 1 hru Notary Public Underwri;cr• _ f 'svaay. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.7/2014