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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q „ Date: Permit Number: RECEP-0 fq( 0 9 2017 1 o I _ 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: v dC .: ........ PRQPOSED IUP:ROVEMENT Address: 7�'`1 jr �.4_F1 Z149 57 Legal Description: Property Tax ID#: a0c3c�Yo 00 ^ Lot No. Site Plan Name: Block No. Project Name: 9'– Setbacks Front Back: Right Side: Left Side: I 7 -(i6� {I I `{,kap � DETAILED DESCRIPTION QF WORK .- .... .. ..:_: _ •___.. _:: 'F..: �.�..... � ..uhf. : _ ":'-� k'.- ©np GONSTRIJCTIOIV INFORIVC'A �' ;`s �r A itiona wor to e per Orme under this permit–check a that apply: 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: $ 3 -'1,9,2 Utilities: —Sewer —Septic Building Height: GONTRACTQR�S '� v n ny � 4�ryi�v �PFj X7 OWNER/LESSEE Name2,2A-r f N ,� l���C¢ Name: Address: 7 9"Y8 P14iv7" ri�iv 6 12I2 Company City:PT 2 Guc/C Stater Address:'SD 5ty PI.xJ3YI�i� Zip Code: �C<3 Fax: City:PT, ST 21 State: Fl– Phone LPhone No.7,-.2- Yle Zip Code: -3 Y If 3 Fax: E-Mail: Phone No 772 Fill in fee simple Title Holder on next page (if different E-Maid from the Owner listed above) State or County License r If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. 5 ' ,f1Vt11�`AL CONSTRUCTION LI1=N LAW INFORMATION 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 cornimencing work or recording our Notice of Commencement. Signatur o Own Lessee/Contractor as Agent for Owner g ature of Contrac r/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 5 k 1r,_,c��-R, COUNTYOF 5 k, 1_ The forgoing instrument was acknowledgd before me The forgoing instrument was acknowledged before me this day of W1ay 20V) by this � day of YNN o.V 20N:� by -4'x a 5-e '0 a ,i ^\ -3-e- (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public- tate of Florida) (Signature of Notary P lic-State of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identificatic _ Type of Identification �°' Produced �- L Produced '� �- '�;�,<' --- .r xrms�r�scscwu....•... a° '. o64NPPA MARIE GNENS _ aj NA MART' IVB i`� MY COMPdISS10 #GG 022023 Q .j-.1'&NNA Commission No. 1CPIRES:� H Commission No. � MPdISSI0N02023 er to"",2020 4• Bonded Thru Notary Public Urwnters nde :o EXPIRES:December 18,2020 l 8�2P' Bonded Thru Notary Public Underm tk�i:. .:a REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 7/2014