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HomeMy WebLinkAboutBuilding Permit Application ____....,....,: ....�c Pkrr&jcATlON TO 8E ACCEPTED u Date: IF 1r�� Permit Number:VI t U RECE1'y'�D ".;'i J 'all Building Permit Application Planning and Develoment Services Building and diode Regulation Division 2300 Virginia Avenue,Fort Fierce FL 34982 Phone:(772)462-1553 Fax(772)462-1578 Commercial Residential PERMIT APPLICATION FOR: RRO►POSED IVIPROVEMENT- OO?i TIflN. Address: legal Description: �2. Property Tax ID#: .q o'�5 A5 =CQ0 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Sack: Right Side: left Side: ©ETAILEt7.DESCiIPT{CiN Cif�JVt?RK. AjdoLu eS:>COQ5 plvo ws��ta,�c. 1,3UM 5,6e ULA e Cu, u©Cdo77 � o CONSTRUCTION INFL KM4TION.' Add it ona workto a performed un er t is permit—check a at app . ` HVAC Gas Tank ^Gas Piping ShuttersWindows/Doors Electric __Plumbing ,_Sprinklers Generator Roof Roof pitch Total Sq.Ft of Construction: a Sq.Ft.of First Floor: Cost of Construction:$ � Utilities: Sewer ! Septic Building Height: C?tAl #`ERjIES$ E r CC} TRAC EN 'OR Name N Name:. = 1.3 % Address; Company: City: doreState'_±- Address: ff)t Ito, Zip Co e: Fax: city: }0A State: t— Phone No.C,���t�Li Zip Code: -)j*'-2)Q Fax: E-Mail: Phone No. Fill In fee simple Title Halder on next page{If different E-Mail: ,Pili .+ l 11 c iy I from the Owner listed above) State or County license: l' `l*C_ IS'?' 1 502 if value of construction is$?SOX or more,a RECORDED Notice of commencement is required. 'S#JPPL /tEN I,CC3NSTRU+ 1{ N # ! LAW INFORMAT10 1 DESIGNERANGINEER: 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: I certify that no work or installation las 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 ruies,bylaws or an 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 usesto another non-residential use WARNING TO OWNER:Your:fallure to Record a Notice of Commencement may result in your paying twice for improvements to your property.A Notice of Commencement must be recordedandposted on the jobsite before the first lnspection If you intend to obtain financing, consult with lender or an attorney before commencing work or recording your Notice of Commencement. „ r c t S Slignat&6 of Owner Les e r as Agent for Owner Signator of Contractor] leen r STATE OF FLORIDA STATE OF FLOR�IIDD� t� N � COUNTY OF ���� -�.: COUNTY OF. The fording instrument was acknowledged before me The forgFing instrument was acknowledged before me this-�day of h-l-Abkd 201 by, this clay of UW14 _ _. ,20 J�- by (Name of person knowledging). (Name of personasa knowl gin ) (Signature of Notary Public-State of Florida (Signature of Notary Public State of Florida) Personally Known OR Produced Identification Personally Known—ZOR Produced identification Type of Ident�cafio Type of ident-i#icatu n Pro aced MAD VELAaCO "°"�.,�`".."' i � t*L- MA 0;E LA',.;J' 'f LASCO Commission No. �': •'e MY COMMOW 0 GG050399 Com Wsslon No. I. CAiiRNiIS ��.�' l} s�05038>i • . EXPIRE!lN0lninber 23,242p ; 4'►{`�;" EXPIRFS 4�c<<mb9.28,2020 Revised 07/15/2014 - REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW. REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS