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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1 17_ Permit Number: - - MAY 19 taw - �- .. Building Permit Application Planning and Development Services R Vv'�r� Building and Code Regulation Division ) 0 P, 1 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: �- PRO aS':E=D INPRQ;yEM,E�NT' LOCATION. Address: C_- &W I C/��`�� Legal Description: /o7- lz ,V.�7 7`1,14%l"zr 41) 3 ©w g 457-j7 Property Tax ID#: :3,? O d 7 Lot No. f �- Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: IN DE AILf�D DE=�S�RITION 0 WOf� . f--A *4" C1-i f}nl&— ;9,9T/-f T✓;5 r G��7a/6c' S6/a w F?LyE'S b��/EST Oj/3T/-/ '- •fi Ew �t�/G� T��'pY.ei .�1/`i9-L 1�1� f1'�^� S��ty,!� GSI PJ �-ra T'i�T/t ' f4 7>f7 7'-OILET e­-ML`7zT F,54-7- X73 CONSTRIJCTI"ON INFQRMAT ON: itiona work to be performed under.tis permit-check all that appy: _Mechanical _Gas Tank _Gas Piping =Shutters Windows/Doors _Electric v'�_Iumbing —Sprinklers —Generator —Roof Pitch Total Sq. Ft of Construction: 6 0 Sq. Ft.of Fi'rstfiFloor:.. I' Cost of Construction:$ '2 15,c?c9 Utilities: _Sewer _Septic Building Height: OW' E; /LESS_EE: 0170,1 MR1MCNATER. Name '_7 EFF Name: Address: Company: City: R.1-177c State:GT Address: 15�Z�3 Zip Code: 0& 3.5 7 Fax: City:ffr��c:r 57-d Gcie State: A-6- �7 n Phone No. :2 D Zip Code: -.3q 4 g 3 Fax: E-Mail: Phone No '7 72 Z Z cf 51l/ O Fill in fee simple Title Holder on next page (if different E-Mail efo�2 PJyi 4 14- ;R °Li from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SeU�PPLE�M'ENT�AL CONSTR�tJ TI'O�N LIEN LAW IN!F®R;MATIO'N: DESIGNER/ENGINEER: . Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEESIMPLE 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 lender or an attorney before commencing work or recording your Notice of Commencement. A EMMC � sI Signature of Owner/Lessee/Contractor as Agent fo O"(nlhrc S nature of Contra for/License Holder m o STATE OF FLORIDA �� STATE OF FLORIDA a X0 a COUNTY OF 2�S -COUNTY OF M;iz� Z�M P3 = The fpr oing instrument was acknowledge cJ before iv z= The forgoing instrument was acknowledged b this day of --1)7F �T this day of P71&in 120� �T Z22 k IV D (Name of person acknowledging) s' (Name of person acknowledging) aea'� ( ignature of Not y Public-State of Flor' a) (Signature of Pry Public-State of Florida) Personally Known OR Produced Identification Personally Known AOR Produced Identification Type of Identification Type of Identification Produced Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.