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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1� Date:Y- z7 - 17 Permit Number:110 Y 2037 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 ResidentialVol" PERMIT APPLICATION FOR: v c PROPOSED INPROUEMENT LOCNT111i Address: 611 EWeQ PiAes efLIr re E-7 Piel _i El 3L1 q Legal Description: Property Tax ID#: I J - ASO I - d('�a- C)00 M Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED 1 &.1IPTION t3F WORK: Ye -�v Z;lKe A e ckc^j oA . - 15 `Ton.► 9 Gi .5zel () i��... EliTUMINN [NF1'RM ►TL©N: Additional workto a per orme under this permit-check a that appy: VMechanical `Gas Tank iGas Piping _Shutters =Windows/Doors_ Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ 3_ `�b Utilities: —Sewer _Septic Building Height: OWNER/LE=�S7SEE: CONTRACTOR: Name Name: GnAi6d+cr�(! . . Address: /�i �c,le� ; iJirleS CoV Company: ;;rTAe City:` (�T ffc'/C�� State: rf Address: LcI03 Ca6cn Gn Zip Code: ,ILI 11 f J Fax: City: f-7 piPrCsZ State: PI Phone No. Z I r - x Q:J - 5"66 h /I Zip Code: '?L4 9 S 1 Fax: f4o f E-Mail: �};i AT-f. ILJe4. Phone No (;(.4o- RggS Fill in fee simple Title Holder on next page(if different E-Mail CCC (r-;r Sd I fes.- a rhe 1 . C a rh from the Owner listed above) State or County License CAC►OKI coo I If value of construction is 2500.or more,a RECORDED Notice of Commencement is required. SIJPPLEMENI'A C®NSTRIJCT'I®N LIEN LAUV INIF©�RMATION 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 cr 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 work or recording our Notice of Commencement. Signature Owner/Less e/Cactor as Agent for Owner Signature oj_ontractorfucn�Hder STATE OF FLORIDA STATE OF FLOW DA COUNTY OF S}-, COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of C% �p%1 20it by this a.< day of O► 20_1]L by (Name of person acknowledging) (Name of person acknowledging (Signature of Notary Pu c-State of Florida) (Signature of Notary Pub'c-State of Florida) Personally Known OR Produced Identificati Personally Known OR Produced Identification Type of Identificatigai 1, �ayp� DEANNAMARIEGPlE1�S Type of Identification Produced 1 COMMISSION#GG022023 Produced 1. �M =�Y _r +: i i - EXPIRES:December 16,2020 ! ;i°"''•:�; >�A1GIARIE Gr-/EN,., t( MY COMPrIISS Commission No. Bond�� �JotaryPublicunderwriters f Commission No. P i@N 022023 ?? J IRES;Del 6,2020 ' 1H.Vf a i�'.•. °E ;°a'•' Bonded Thru Notary Public Undery;.Iran.. ; REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 7/2014