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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �J1y ` �`1 Permit Number: T . : R E C E 1'.' D ":,iJ J 2017 as M�w 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: -, VEM PRC}POSED INPR(3a Address: IS- ��- Legal Description: oqz/ '� f3/ Property Tax ID#: CQ2 - (oo9--0 5 70- 00,0 3 Lot No. Site Plan Name: Block No. Project Name: %f Dn j ve R-,D eGf Setbacks Front Back: Right Side: Left Side: �DE�AILEO DESRIPTIQNfWQRK� � I,ih�� �� ��" a �ilh� i E`' ra. d a 2 A—,1 e- © 4/ Ct S Y1�taiP S 16 6'—�blln Sb.Licn�9 LTtTI— t CQ��tSTCT(CY1 INfi „I,NMI,,�FRUM Additional work tobe performed under T art ear this permit-check a that appy: _Mechanical _Gas Tank Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ ,���,yo Utilities: _Sewer _Septic Building Height: � �y �+j ��It .. 01LESS .. �r�� CC�NTRATQRr r'" r r34 r "`rr 3a6}r �a+.'�'..,-^e^c`".r'.' *;si ?.r} N�, x_ ,:-l:l;i .�,»_* r".. -rs.0 at.nr . •wea� l �ak r-=.. �. Named . . Ci Name: Address: 2WI;Z� ° ,company: City: State:_ Address':,. /,--? Zip Code: p tFax: City: 2X State Phone No. , . 0 2O 7G2��/ Zip Code: 3V9V-7 C�9� Fax: E-Mail:/ l�e2d�;,,7` ��'�`L�f` C�1v1 Phone No c--77--Ji O �o'9/ Fill in fee simple Title Holder on next page( if different E-Mail U'-PC!5-. lj Cao/04/% . �6> from the Owner listed above) State or County License CGc; If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. rM 5� 'P=�.�nIEN'T' C-0 ; ' E cT�a( N I It � ,� gra ' C r k d`y 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 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 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. _Sign ure of Owner/L see/Contractor as Agent for Owner Signatu of'Co,ntract /Lic se Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF LUc�% COUNTY OF :!�+, 1--Z The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this IN,day ofVv2a 20-Q by this 1:�day of Ytv t\-4 20-qby (Name of person acknowledge ) (Name of person acknowle(Vng) (Signature of Notary Pu lic-State of Florida) (Signature of Notary blic-State-of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identific tion `___1 Type of Identificatio Produced T L �L - "WT I Produced IV ••J DEANNAMARIEGNENS pNAMARIEGNENS , ••'w'r'•'v'u•••,,� I,�I�g10N#GG 022023 •# MY COMMISSION MARIE; GG 022023 Commission No. MS I ecember16,2020 Commission No. 'l� EXPIRES:p woo 16,2020 +r b? BandedThruNotary Pubft Underwrters ., o ff Flo,, nded Thni Naatta'ry u lie underwriters y,OFF p REVIEWS FRONT ZONING__ SUPERVISOR PLANS VEGETATION SEATURTLE - MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.